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UNIT M ROUND STORAGE:TANK <br /> MONITORING SYSTEM CERTIFICATION FORM {Fa•IARr,trl <br /> _ _ _ X11._ .LINE LEAK OEIECTOR VESTING <br /> 8C--Chhick_this b X_If lino teak dotectvrs(LLE))aro NOT Installed (W not rvinpfate trilo cinorinj are Y N NA <br /> This soctlan must be complotod it L.Lps ains�_ ffiad Y - <br /> Was Bleak simulated to vflnfy LLf]porfDrmanco7 � �'] [] <br /> Check all tha�ply. Slmutatgd leak rata verltied: 3 GRI 4,y rf'_f I ❑U?r 4�1 I <br /> Was the tasting apparatus properly calibrated? � r..wr . �_,. I 1 ❑ <br /> For emergency generator tank systema,does the LLD create an audible and visual alarm when a ie:ak le detected? <br /> For mechenical LLDs,does the LLD restrict the flow through tho pipe when a leak is detasctdcl? <br /> For electronic LLDs.does the turbine automatically shut off when a leak is detected? T _ © ❑ ❑ <br /> For electronic LLDs,does the turbine automatically shut off If any portion of the monitoring system in disabled at dinconnectorl? a ❑ •_© <br /> For electronic LI-Ds,does the turbine automatically shut off If any portion ofhis m <br /> tonitorin!�system malfunctions or fella a that? <br /> For electronic LLDs,have all accessible wiring connections been visually Inspected for kinks and broaks? w <br /> Were all Nems on the equipment manufacturer's maintenance checklist completed? I] <br /> Were all LLDs confirmed operational within regulatory requirements? __ ❑ ❑r 0 <br /> For any answer of"14"above,describe In section X111 how and when thaaso tssaros worn or will be corroc[ar! - <br /> - -- - "xitl. -coMMENTs . ... _ _.. <br /> XIV. VACUUM/PRESSURE/HYDROSTATIC MONITORING EQUIPMENT TESTING <br /> Check this box if VPH mon kering is NOT used. (Do not complete this section) <br /> Th1s section must be completed If VPH rnonitoiing Is used to perform leak detection monitoring. <br /> System Type(Mark ail that apply.) ❑Vacuum ❑Pressure ❑Hydrostatic <br /> Sensor ID Cam anent s Monitored b this Sensor Sensor Functionality Interstitial Corromunicaton <br /> p ( ) Y Test Test <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> [3 Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fail 0 Pass ❑Fall <br /> ❑Pass 0 Fail [I Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass [j Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fait ❑Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> How was interstitial communication verified? ❑Simulated leak at far ends of the interstitial space_ [I Visual Inspection <br /> ❑Other(Describe the method to sectJon XV below.) ❑Gauge <br /> Was the vacuum or pressure restored to operating levels in all interstitial spaces? ❑Yes ❑No(Describe the reason in section XV below.) <br /> For any answer of"FAIL"above describe in section XV how and when these issues were or will be corrected. <br /> XV. COMMENTS <br /> GPH=Gallons per hour,Y-Yes,N�No,NA=Not applicable,VPH=VaeGiumlPressurQJi-lydrostatic,1p=Identification <br />