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Underground Storage Tank Monitoring System Certification Form 7. LINE LEAK DETECTOR TESTING ❑✓ Check this box if line leak detectors ARE NOT installed. (Do not complete this section.) Simulated release rate verified: (Check all that apply.) Yes No NA ❑ 3 GFH ❑ 0.1 GPH ❑ 0.2 GPH Has the testing apparatus been properly calibrated? ❑ ❑ ❑ For emergency generator tank systems, does the LLD create an audible and visual ❑ ❑ ❑ alarm when a leak is detected? For mechanical LLDs, does the LLD restrict the flow through the pipe when a ❑ ❑ ❑ release is detected? For electronic LLDs, does the turbine automatically shut off when a release is ❑ ❑ ❑ detected? For electronic LLDs, does the turbine automatically shut off if any portion of the ❑ ❑ ❑ monitorings stem is disabled or disconnected? For electronic LLDs, does the turbine automatically shut off if any portion of the ❑ ❑ ❑ monitoring system malfunctions or fails a tightness test? For electronic LLDs, have all accessible wiring connections been visually inspected ❑ ❑ ❑ for kinks and breaks? Were all items on the equipment manufacturer's maintenance checklist completed? ❑ ❑ ❑ Were all LLDs confirmed operational within regulatory requirements? ❑ ❑ ❑ Describe all answers marked "No" or "Fail" and proposed remedy in Section 9. List all monitoring equipment either replaced or repaired in Section 9 Page 4 of 6 LLD ID LLD Model Lines Monitored Pass Fail N/A N/A N/A ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Describe all answers marked "No" or "Fail" and proposed remedy in Section 9. List all monitoring equipment either replaced or repaired in Section 9 Page 4 of 6