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Section 12: Release Detection (cont’d.)

[ ] Applicable [ ] Not Applicable

Section 12.a. Automatic Tank Gauging (Tank Only)

  • #

    Complete 1 and 4. Answer (P)ass,

(PC), or (F)ail for 2,3,5 10.

Tank #

__

Tank #

__

Tank #

__

Tank #

__

Tank #

__

1

Console Make and Model

Make: Model:

2 3

Monitoring console is working.

Owner's manual for console and probes is available at site.

4

Frequency ATG performs test (D) daily, (W) weekly, or (M) monthly.

5

Device is calibrated, operated, and maintained per manufacturer's instructions in addition to limitations listed on evaluation summary NWGLDE* list.

6

System setup reviewed and system capable of verifying probe(s) are functioning and documenting results.

6a.

Attach copy of print out for the last monthly ATG tank leak test to this page.

7

Tank is filled to proper capacity and test run for proper duration of time for last 2 months per NWGLDE* list.

8

Verification that console and probe are third party approved and on the NWGLDE* list. Monthly release detection records are available and reviewed for past 12 months.

9

10

Existing release detection results reviewed shows no failure.

ATG passes inspection. Questions 2, 3 and 5 – 10 are (P) or (PC)

Note: If the answer to any question is (F), explain below. List any problems noted during inspection. Note corrections. *www.nwglde.org (National Work Group on Leak Detection Evaluations).

Comments:

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Form Number: MDE/WAS/COM.055 Date: April 3, 2007 TTY Users: 800-735-2258

Facility I.D.

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