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MOFAM <br /> og <br /> • <br /> Has all input wiring been inspected for proper entry and termination,including testing for ground_fa__W__tS? <br /> I"Mr,M11 <br /> van—= <br /> —rr,A—"M I <br /> RM, I, ra"IMMIM 6 L Mi=0 M� <br /> I{ �.rff &104771151,"It 4-11 1' -,.1 lug I -1 <br /> I <br /> For equipment start up or ammal equtipment qXfficaftom was a leak simulated to verify LLD performance'? <br /> (Check all that apply) Simulated leak rate: [!r3g.p.11.1; 00.1gp.lt.2; 00.2&P.IL2 <br /> Notes: L Required for equipment start-up cerfification.and annual certification. <br /> I Unless mandated by local agency,ceriification.required only for ei=trDmc LLD SM-up <br /> ra"EML&T.—tt 7119 P 4 Woo j1PIMVAW-.;-7MTMMr; <br /> For mechamcal LLDs,does the LLD restrict product flow if it detects a leak? <br /> T"AT71MOIR11 M577117;141 11*11 IrMoll I(M opts 1 4; <br /> of '11 <br /> lffw"Z=� For eliectronic I.LDs, does the turix—ne automatically-shut-aff---if any portion of the monitoring system, <br /> inaffimictions or&ds a test? <br /> For electronic LLDs, bave all accessible wiring connections been visually inspected? <br /> I M <br />