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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.) ❑✓ 3 GPH ❑ 0.1 GPH 0.2 GPH Yes No NA 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 monitoring system 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? ❑ ❑✓ ❑ LLD ID LLD Model Lines Monitored Pass Fail Q1 VR8484 REGULAR 15-22 ❑ ❑✓ Q2 VR8484 REGULAR 1-14 ✓❑ ❑ Q5 VR8484 PREMIUM 15-22 ✓❑ ❑ Q6 VR8484 PREMIUM 1-14 ❑✓ ❑ W1 849490-003 DIESEL ❑✓ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 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