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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 /> 0 3 GPH ❑ 4.1 GPH ❑ 0.2 GPH <br /> Has the testing apparatus been properly calibrated? A J Lj <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 flaw through the pipe when a ® Ll ❑ <br /> release is detected? <br /> For electronic LLDs, does the turbine automatically shut off when a release is Ll Ll <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 Ll Ll <br /> mon itoring system malfunctions or fails a tightness test? <br /> For electronic LLDs, have all accessible wiring connections been visually inspected ❑ ❑ V1 <br /> for kinks and breaks? <br /> Were all items on the equipment manufacturer's maintenance checklist completed? ® Ll ❑ <br /> Were all LLDs confirmed operational within regulatory requirements? 2 <br /> LLD ID LLD Model Lines Monitored Pass Fail <br /> T1 Vaporless LD-2000 RUL R] Lj <br /> T2 Vaporless LD-2000 PUL 0 ❑ <br /> I❑ ❑ <br /> El ❑ <br /> I❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> Describe all answers marked `'No"or `Fail"and proposed remedy in Secrion 9. <br /> List all monitoring equipment either replaced or repaired in Section 9 <br /> Page 4 of 6 <br />