COMPLIANCE INFO_2020 - Laserfiche WebLink

Home Browse Search

UNDERGROUND STORAGE TANK MONITORING SYSTEM CERTIFICATION FORM ( Page 5 of 6) XII . LINE LEAK DETECTOR TESTING ❑ Check this box if line leak detectors (LLD) are NOT installed . (Do not complete this section.) Y N NA This section must be completed if LLDs are installed. Was a leak simulated to verify LLD performance? ❑X ❑ ❑ (Check all that apply.) Simulated leak rate verified : ❑X 3 GPH ❑ 0. 1 GPH ❑ 0.2 GPH Was the testing apparatus properly calibrated? 0 ❑ ❑ For emergency generator tank systems , does the LLD create an audible and visual alarm when a leak is detected ? ❑ El x For mechanical LLDs , does the LLD restrict the flow through the pipe when a leak is detected ? ❑ ❑ Q For electronic LLDs , does the turbine automatically shut off when a leak is detected ? QX ❑ ❑ For electronic LLDs , does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? ❑X ❑ ❑ For electronic LLDs , does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? ❑X ❑ ❑ For electronic LLDs , have all accessible wiring connections been visually inspected for kinks and breaks? ❑X ❑ ❑ Were all items on the equipment manufacturer's maintenance checklist completed? NX El Were all LLDs confirmed operational within regulatory requirements? X❑ ❑ ❑ For any answer of "N" above, describe in Section Xlll how and when these issues were or will be corrected. X111 . COMMENTS XIV. VACUUM / PRESSURE / HYDROSTATIC MONITORING EQUIPMENT TESTING ❑ Check this box if VPH monitoring is NOT used . (Do not complete this section.) This section must be completed if VPH monitoring is used to perform leak detection monitoring. System Type (Mark all that apply.) ❑X Vacuum ❑ Pressure ❑X Hydrostatic Sensor ID Component(S) Monitored By This Sensor Sensor Functionality Interstitial Communication Test Test S1 87 PRODUCT ❑X Pass ❑ Fail ❑X Pass ❑ Fail S2 87 VENT ❑X Pass ❑ Fail ❑X Pass ❑ Fail S3 87 VAPOR QX Pass ❑ Fail ❑X Pass ❑ Fail S4 91 PRODUCT ❑X Pass ❑ Fail ❑X Pass ❑ Fail S5 91 VENT ❑X Pass ❑ Fail ❑X Pass ❑ Fail S6 DIESEL PRODUCT ❑X Pass ❑ Fail ❑X Pass ❑ Fail S7 DIESEL VENT ❑X Pass ❑ Fail ❑X Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail i ❑ Pass ❑ Fail ❑ Pass ❑ Fail How was interstitial communication verified ? ❑X Simulated Leak at Far Ends of the Interstitial Space Visual Inspection ❑ Other (Describe the method in section XV below.) Gauge Was the vacuum or pressure restored to operating levels in all interstitial spaces? ❑X Yes ❑ No (Describe the reason in section XV below.) For any answer of "Fail' above, describe in Section XV how and when these issues were or will be corrected. E XV. COMMENTS GPH = Gallons Per Hour, Y = Yes, N = No, NA = Not Applicable, VPH = VacuumlPressureMydrostatic, ID = Identification I' i