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This section must be comnleted if 4- -H . ........ <br />R Check Us box if Auginais used on] f.: I I <br />U-MMIR M -'W <br />Com fete the foilawing checklist: <br />E Y Ye <br />es E3 No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />Yes <br />Yes U Na* Were all tank gauging probes visually inspected for damage and residue buildup? <br />Y <br />Os <br />E3 Yes E3 No* Was accuracy of system product level readings tested? <br />s <br />U es U No* Was accuracy of system water level readings tested? <br />AYesYes <br />LI No* Were all probes reinstalled properly? <br />Yes E3 No* I Were all items on, the equipment manu&cMw5s maintenance checklist completed? <br />In the Section H, below, describe how and when these deficiencies were or will be corrected. <br />G. Line Leak Detectors (LLD): <br />Complete the followino ch"-L-liet- <br />LI Check this box if LLDs are not installed. <br />01 Yes <br />U No* <br />LI N/A <br />For equil)ment'Aart-W Or annual equipment certification, was a leak simulated to verify LLD performance? <br />(Check all that aPPIY) Simulated leak rate: M 3 g.p.h.; 0 0.1 g.p.h ; E3 0.2 g.p.h. <br />Yes <br />0 No* <br />Were all LLDs confirmed operational and accurate within regiflatoly requirements? <br />Yes <br />Yes <br />U No* <br />Was the testing apparatus properly calibrated? <br />Yes <br />E3 No* <br />E3 N/A <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />P <br />E3 Yes <br />Yes <br />U No* <br />W N/A <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />[Q1 <br />E3Yes <br />E3 N6* <br />R. 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 />E3 Yes <br />0 No* <br />2L N/A <br />For electronic LLDs, does the hubmezutomatically shut off if any portion of the monitoring system malfunctions <br />or fails a test? <br />LI Yes <br />E3 No* <br />11 N/A: <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />13 Yes <br />El No* <br />Were all hems on the equipment manuflichm's maintenance checklist completed? <br />In the Section <br />IL <br />below. describe how and when thea- dPfIPIPn&;&a v...,..® t— <br />H. Comments: <br />Page 3 of 3 03/01 <br />