Laserfiche WebLink
UNDERGROUND STORAGE TANK <br />MONITORING SYSTEM CERTIFICATION FORM (Page 5 of 6) <br />GPH =Gallons per hour, Y = Yes, N = No, NA Not <br />XVI. ` LINE LEAK DETECTOR TESTING <br />F Check this box if line leak detectors (LLD) are NOT installed. (Do not complete this section.) <br />This section must be completed if LLDs are installed. <br />Y <br />N <br />NA <br />Was a leak simulated to verify LLD performance? <br />(Check a// that apply,) Simulated leak rate verified: r 3 GPG r 1.1 GPG r"` 0.2 GPH <br />Was the testing apparatus properly calibrated? <br />�- <br />r <br />For emergency generator tank systems, does the LLD create an audible and visual alarm when a leak is detected? <br />r <br />r <br />r <br />For mechanical LLDs, does the LLD restrict the flow through the pipe when a leak is detected? <br />r <br />r <br />FVO <br />For electronic LLDs, does the turbine automatically shut off when a leak is detected? <br />I✓ <br />r <br />r <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br />ry <br />r <br />r <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br />Iyo <br />r <br />r <br />For electronic LLDs, have all accessible wiring connections been visually inspected for kinks and breaks? <br />I✓ <br />r <br />r <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />Iv <br />r <br />Were all LLDs confirmed operational within regulatory requirements? <br />Iv <br />r <br />r <br />For any answer of "N" above, describe in section X111 how and when these issues were or <br />will be corrected. <br />Xlll. COMMENTS <br />XIV. VACUUM / PRESSURE/ HYDROSTATIC MONITORING EQUIPMENT TESTING <br />r` Check this box if VPH monitoring is NOT used. (Do not complete this section.) <br />This section must be completed if VPH monitoring is used to perform leak detection monitoring. <br />S stem Type (Mark all that app/ f7 Vacuum r Pressure r Hydrostatic <br />Sensor lD <br />Component(s) Monitored, by this Sensor <br />Sensor Functionality <br />Test'+ <br />Interstitial <br />Communication <br />Test <br />S1 <br />87 PROD. LINE <br />r Pass r Fail <br />Iv <br />Pass <br />r <br />Fail <br />S2 <br />91 PROD, LINE <br />F Pass r Fail <br />r <br />Pass <br />r <br />Fail <br />S3 <br />DSL PROD. LINE <br />I+' Pass r Fail <br />17 <br />Pass <br />r <br />Fail <br />S4 <br />87 STP SUMP <br />P Pass r Fail <br />W <br />Pass <br />r <br />Fail <br />S5 <br />87 FILL SUMP <br />W Pass r Fail <br />r <br />Pass <br />r <br />Fail <br />S6 <br />91 STP LINE <br />I✓' Pass r Fail <br />h <br />Pass <br />r <br />Fail <br />S7 <br />91 FILL SUMP <br />W Pass r Fail <br />W <br />Pass <br />r <br />Fail <br />S17 <br />DSL STP SUMP <br />r Pass r Fail <br />i✓ <br />Pass <br />I® <br />Fail <br />S18 <br />DSL FILL SUMP <br />I0 Pass r Fail <br />ry" <br />Pass <br />r <br />Fail <br />S19 <br />ALL VENTS <br />W Pass r Fail <br />P <br />Pass <br />r <br />Fail <br />S20 <br />V.R. ALL UDCS <br />W Pass r Fail <br />F <br />Pass <br />r <br />Fail <br />r Pass r Fail <br />r <br />Pass <br />I® <br />Fail <br />How was interstitial communication verified? r Simulated leak at far ends of the interstitial space. <br />r Other (Describe the method in section XV below.) <br />r <br />rvv <br />Visual Inspection <br />Gauge <br />Was the vacuum or pressure restored to operating levels in all interstitial spaces? r Yes r No (Describe the reason <br />in section <br />XV below.) <br />For any answer of "N" above, describe in section Xlll how and when these issues were or <br />will <br />be corrected. <br />XV. COMMENTS <br />applicable, VPH =Vacuum/Pressure/Hydrostatic, ID =Identification <br />