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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 7 . LINE LEAK DETECTOR TESTING <br /> ❑ 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 /> N 3 GPH ❑ 0 . 1 GPH ❑ 0 . 2 GPH <br /> Has the testing apparatus been properly calibrated ? N ❑ ❑ <br /> For emergency generator tank systems , does the LLD create an audible and visual ❑ ❑ N <br /> alarm when a leak is detected ? <br /> For mechanical LLDs , does the LLD restrict the flow through the pipe when a N ❑ ❑ <br /> release is detected ? <br /> For electronic LLDs , does the turbine automatically shut off when a release is ❑ ❑ N <br /> detected ? <br /> For electronic LLDs , does the turbine automatically shut off if any portion of the monitoring ❑ ❑ N <br /> system is disabled or disconnected ? <br /> For electronic LLDs , does the turbine automatically shut off if any portion of the ❑ ❑ N <br /> monitoring system malfunctions or fails a tightness test ? <br /> For electronic LLDs , have all accessible wiring connections been visually inspected ❑ ❑ N <br /> for kinks and breaks ? <br /> Were all items on the equipment manufacturer ' s maintenance checklist completed ? N ❑ ❑ <br /> Were all LLDs confirmed operational within regulatory requirements ? N ❑ ❑ <br /> LLD ID LLD Model Lines Monitored Pass Fail <br /> #1 = Reg VR FX1V Regular N ❑ <br /> #2 - Prem VMI LD2000 Premium N ❑ <br /> #3 - Dies VMI LD2000 Diesel N ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <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 />