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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 7. LINE LEAK DETECTOR TESTING <br /> C 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 /> 0 3 GPH r 0.1 GPH 0 0.2 GPH <br /> Has the testing apparatus been properly calibrated? 0 ❑ ❑ <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 <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 <br /> monitoring system malfunctions or fails a tightness test? <br /> For electronic LLDs, have all accessible wiring connections been visually inspected 17 17 0 <br /> for kinks and breaks? <br /> Were all items on the equipment manufacturer's maintenance checklist completed? ® r] <br /> Were all LLDs confirmed operational within regulatory requirements? <br /> LLD ID LLD Model Lines Monitored Pass Fail <br /> T3 T4 T5 T6 99 LD-3000 West Side Tank Farm Dispensers 25 24 23 22 21 ❑✓ In <br /> T7 T8 T9 T10 99 LD-3000 East Side Tank Farm Dispensers 20 19 18 17 191 ❑ <br /> In IF] <br /> o a <br /> V1 a <br /> Irl <br /> IM <br /> 10 <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 4 of 6 <br />