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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 7. LINE LEAK DETECTOR TESTING <br /> Ll Check this box if line leak detectors ARE NOT installed. (Do not complete this section.) <br /> Simulated release rate verified: (Check all that apply.) Yes No NA <br /> ❑✓ 3 GPH ❑ 0.1 GPH ❑ 0.2 GPH <br /> Has the testing apparatus been properly calibrated? ❑✓ ❑ ❑ <br /> For emergency generator tank systems, does the LLD create an audible and visual ❑ <br /> alarm when a leak is detected? <br /> For mechanical LLDs, does the LLD restrict the flow through the pipe when a ❑ ❑ <br /> release is detected? <br /> For electronic LLDs, does the turbine automatically shut off when a release is 0 0 M✓ <br /> detected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the <br /> monitoring system is disabled or disconnected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the © ❑ 0 <br /> monitoring system malfunctions or fails a tightness test? <br /> For electronic LLDs, have all accessible wiring connections been visually inspected ❑ 0 <br /> for kinks and breaks? <br /> Were all items on the equipment manufacturer's maintenance checklist completed? 171 0 In <br /> Were all LLDs confirmed operational within regulatory requirements? r✓ 0 0 <br /> LLD ID LLD Model Lines Monitored Pass Fail <br /> T1 99LD2000 Diesel Main ❑✓ 0 <br /> T2 99LD2000 Diesel Reserve ✓❑ 0 <br /> 0 0 <br /> ❑n 0 <br /> ❑ ❑ <br /> © D <br /> ® D <br /> ® D <br /> D D <br /> D D <br /> ❑ D <br /> 0 C <br /> Describe all answers marked "No"or "Fail"and proposed remedy in Section 9. <br /> List all monitoring equipment either replaced or repaired in Section 9 <br /> Page 4of6 <br />