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e <br /> Oct 20 03 08: 58a P• 4 <br /> F. b-Tank Gauglug I Sill rvillipulen9: Licheck this box if tank ganging is used only for inventory contrr. <br /> U Check this box if no tank gauging or Stat equipment is installec <br /> This section must he completed i f ill-tank g:tttginl, rtluipincnt is ttsed to perform leak detectioat monitoring. <br /> Complete the following ciaecidist: _ <br /> r(03Yes <br /> ❑ No* Has all input wiring been inspected for <br /> proper entry and termination,including testing for ground faults? <br /> O No* Were all tack gmn6ing prohes visually inspected For(lot go and residue buildup? <br /> O No* Was accuracy of system product level readings tested'? <br /> p No* Was accuracy of syslcm water level readings tested? <br /> ® No* Were all probes reinstalled properly?❑ No* Were all items on lite egnipnncut maunfacturer's maintenance checklist completed? <br /> *in the Section H,below,describe how and when these deficiencies were or will lie corrected. <br /> G. Une Leak Detectors U Clirck This box il't.l.t3s are not installc�t, <br /> Com ete the following checklist: _ __..____ <br /> Yea O No" For equipment start-up or amneal equipment ce ln•do ,Q las a leak simulated <br /> im g t d t verify LLD perf®rntancl <br /> O NIA (Check all that apply) Simulated leak rate: 3 g.p. !;P <br /> yes O No* Were alt LLDs confirnRed operational and accurate within regulatory requirements? <br /> es O No* -Was the testing apparatus properly calibrated? <br /> Yes O No* Far mechanical LLDs,does tine 1.1,1)restrict product now if it detects a leak? <br /> O NIA <br /> O yes O N * For electronic Ll,t)s,does the luthnte aulornatically since off if the L.l.t)detects a leak? <br /> NIA <br /> ® YesVNO <br /> * For electronic LLDs, does the hnhine automatically sluts off if any portion or the monitoring system is disable l <br /> fA or disconnected? <br /> 0 Yes ❑ No* For electronic LLDs, does the luthate automatically shut off if any portion of the monitoritag syatel <br /> malfunctions or fails a test'? <br /> p y ❑_ ]q * For electronic 1.LDs,Have all acressible wiring conttections been visually inspected? <br /> C ZA <br /> yes ❑ No* Wer®all items on the egnipnient manutacturcr's maintenance checklist completed? <br /> * <br /> in the Section H,below,describe how and when tieese drticiencies were or will be corrected. <br /> OYOI <br /> Page 5 of 6 <br /> s <br />