Laserfiche WebLink
Rpr 15 05 11:27a Rf da -Test t20 784-0112 p.6 <br />r ftlupi�'%Ttlt� ti�rctem C'ertiGcalimt <br />p, <br />Site Address: _ ,k �' r!�' a _. V•-- ..... _. _ s. <br />t�ieck this box if tank gaining it used only for inventory control. <br />F. in -Tank Gauging / Silt Equipnncnt: <br />U ('heck this box if no tank gaugin�t or $11Z cyttipment is installed. <br />tit is tlsc;(i to per['ul'!n leak ddrtct;tion monitoring. <br />This section trust <br />be c;onipleted il' ilt-tank galiglug u(iuipinc <br />Complete the f®tiowint; checklist: <br />been inspected for proper entry and termination, including testing for ground faults. <br />❑ Yes 0 Nu <br />t las all input wiring <br />visu,Illy d �t>�',�latllfll;c ilnd rCSIdtIC h111{dUh? <br />® Yc8 Q Nos <br />Were till tank gau};ing probes <br />of system product Ievcl rcadi�)Gs tested'? <br />❑ Yes 13 No* <br />Was accuracy <br />Was accuracy of system water level roadings tested'? <br />❑ Yes O No" <br />O Yes Q No <br />Were all probes reinstalled properly'? <br />a 9lreklist ca,►plcled'? <br />O Nos <br />Were all items 41�th,tilpmcot 1natlutincluli r'K ntnintenance <br />C1 Yes <br />def5cieneies were or will he correcte d. <br />" scrilw' how and wilen Uletic <br />In the Section H. below, dc <br />Line Leak Detectors <br />(1,LD): u Cheek this box if LLDs arc not installed. <br />G. <br />Complete the following Checklist: <br />annual equipment certification, was a Irak simulated to verify [,1_D pe ormancc <br />Yes Q Nos <br />For equipment start-up or <br />that Simulated leak rate: L+T`g`p.h•: O 0.1 g.p•Il -,❑ p.2 &.p.h. <br />❑ N/A <br />(<.1hcc'k call crppIV) <br />operational and accurate within regulatory requirements? <br />U Nos <br />Werc ull 1.LDs evnCenncd <br />�, ❑ Nos <br />Was the testing app. *properly calibrated? <br />flow if it detect-, a leak'? <br />l�or 11 mecha11 n 11 i 11 cal t.LDs, docs the LLD restrict product <br />yes ONO* <br />❑ N/A <br />docs tltc turbine automatically shut o11 if the LL.D detects a leak? <br />0 Yes 0 Nos <br />For electronic LLUx, <br />O -VA <br />* <br />hor electronic LU)s, doer the turbine autotnsttically shut o1'f if any portion of the monitoring system is dtsa <br />L3 yes O N <br />N/A <br />or disconnected'? <br />turbine acltUmaltcally shut off if any portion of the monitoring syste <br />❑ yes El No* <br />1'or' electronic LUX (Ines Ile <br />/A <br />malfunctions or fails a test? <br />been visually inspected'? <br />U Ycs Q Nos <br />l�or electronic LL1)s, hi►vc uti accessible wirinc cunneetiont <br />I N/A <br />Were all items on the equipn,cltt mm,uracturer's mtiintcnattce checklist completed? <br />Yes U Nos <br />" In the Section ti, below, describe how and when these del9cieneies were or will be corrected. <br />)E1. Comments: — <br />A'f't i Molitor F or <br />Pq <br />