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Section 12: Release Detection (cont’d.)

Section 12.f. Manual Tank Gauging (Tank Only)

[ ] Applicable [ ] Not Applicable

#

Answer 15 (P)ass, (PC), (F)ail or (NA) for each Tank

1 2

Tank is 550-gallons or less.

Tank is 551 to 2,000-gallons. Note: Must be combined with tightness testing.

3

Gauging stick is capable of measuring the full height of the tank to the nearest 1/8” in conjunction with the appropriate tank calibration chart on site.

4 5

Monthly log is maintained. * Last 12 months of records show no failure.

Tank #

__

Tank #

__

Tank #

__

Tank #

__

Tank #

__

Manual Tank Gauging passes inspection. Questions 1 or 2 and 3–5 are (P) or (PC)

Note: If the answer to any question is (F), explain below. List any problems noted during inspection. Note corrections.

  • *

    See Inspector guidance book or COMAR 26.10.05.04C. for weekly and monthly variation standard.

C o m m e n t s : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

[ ] Applicable [ ] Not Applicable

Section 12.g. Safe Suction (Suction Piping Only)

#

1

2

Answer (P)ass, (F)ail, or (PC) for each i e The piping slope is back to the tank and operates under atmospheric pressure or less. Confirm a single check valve is located directly under the dispensing pump.

Pipe #____

Pipe #____

Pipe #____

Pipe #____

Pipe #____

Safe Suction passes inspection. Questions 1 and 2 are (P) or (PC) Note: If the answer for 1or 2 is (F), another type of release detection must be used and inspected. Fill out the applicable section on piping release detection. List any problems noted during inspection. Note corrections.

C _ _ _ _ _ _ omments:_________________________________________________________________________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

[ ] Applicable [ ] Not Applicable

Section 12.h. Automatic Line Leak Detectors (Pressurized Piping Only)

#

1

2

Complete 1 Answer questions 2 7 (P)ass, (F)ail or (PC) Mechanical or Electronic (M - Mechanical or E - Electronic) Is the equipment on the NWGLDE* list.

Pipe #

Pipe

Pipe

Pipe

Pipe

#

#

#

#

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

Facility I.D.

_________________

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