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`,. <br />F. In -Tank Gauging / SIR Equipment: Check this box if tank gauging is used only for inventory control. <br />❑ Check this box if no tank gauging or SIR equipment is installed. <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />❑ Yes ❑ No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />❑ Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? <br />❑ Yes ❑ No* Was accuracy of system product level readings tested? <br />❑ Yes ❑ No* Was accuracy of system water level readings tested? <br />❑ Yes '3 No* Were all prdbes reinstalled properly? <br />❑ Yes ❑ No* Were 01 items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section H, below, describe how and when these deficiencies were or will be correctkd. <br />G. Line Leak Detectors (LLD): <br />C_mmnletp the fnllnw;na rhPA-1;ct- <br />0 Check this box if LLDs are not installed. <br />Yes <br />❑ No* <br />❑ N/A <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br />(Check all that apply) Simulated leak rate:3 g.p.h.; ❑ 0.1 g.p.h; El0.2 g.p.h. <br />Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />{� Yes <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />.? Yes <br />❑ No* <br />❑ N/A <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ Yes <br />❑ No* <br />0 N/A <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ Yes <br />❑ No* <br />Q N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />or disconnected? <br />❑ Yes <br />❑ No* <br />A N/A <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions <br />or fails a test? <br />❑ Yes <br />❑ No* <br />0 N/A <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />Yes <br />❑ No* <br />Were ail items on the equipment manufacturer's maintenance checklist completed? <br />* In the Section H, <br />below. describe how and when thecP d4ftrePnA.-c wAP — ..,:n hP nn-f.A <br />H. Comments: <br />Pal;c 3 of 3 03101 <br />