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13 <br />F. In -'Wank Gauging / SIR L+ entA ging 's used only aas inVentof`✓ coF3t ri. <br />9 Check this box if ring i s <br />❑ Check this box if no ta,: , gauging or SIR equipment is installed. <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoi-ing. <br />Complete the fnMiwintr rheslrli.+- <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />❑ No* <br />❑ No* <br />❑ No* <br />Has all input wirinb "een inspected for proper entry and termination, including testing for ground faults? <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />Was accuracy of system product level readings tested? a <br />❑ Yes <br />❑ No* <br />Was accuracy of system water level readings tested? <br />❑ Yes <br />❑ No* <br />Were all probes reinstalled properly? <br />❑ Yes <br />❑ No* <br />Were all 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 corrected. <br />G. Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />CdLlete the fnllawina rhnrlrliet- <br />Yes <br />❑ No* <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? <br />❑ N/A <br />(Check all that apply) Simulated leak rate: 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />Yes <br />❑ No* <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />es <br />❑ No* <br />Was the testing apparatus properly calibrated? <br />Yes <br />❑ No* <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />❑ N/A <br />❑ Yes <br />❑ o* <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />N/A <br />❑ Yes <br />❑ No* <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled <br />N/A <br />or disconnected? <br />13 Yes <br />❑ o* <br />For electronic LLDs, does the turbine automatically shut offi, if any portion of the monitoring system <br />N/A <br />malfunctions or fails a test? <br />❑ Yes . <br />❑ o*LForelectronic <br />LLDs, have all accessible wiring connections been visually inspected? <br />N/A❑ <br />No*e <br />all 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 corrected. <br />H. Comments: <br />Page 3 of 3 <br />03/01 <br />