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Underground Storage Tank <br />Monitoring System Certification Form <br />7. LINE LEAK DETECTOR TESTING <br />LJ Check this box if line leak detectors ARE NOT installed. (Do not complete this section.) <br />Simulated release rate verified: (Check all that apply.) <br />0 3 GPH L 0.1 GPH LJ 6.2 GPH <br />Yes <br />No <br />NA <br />Has the testing apparatus been properly calibrated? <br />0 <br />J <br />Lj <br />For emergency generator tank systems, does the LLD create an audible and visual <br />alarm when a leak is detected? <br />LA <br />LA <br />A <br />For mechanical LLDs., does the LLD restrict the flow through the pipe when a <br />release is detected? <br />El <br />® <br />Ll <br />l] <br />For efectronic LLDs, does the turbine automatically shit off when a release is <br />detected? <br />For efectronic LLDs, does the turbine automatically shut off if any portion of the <br />mon ito-ring system is disabled or disconnected? <br />For electronic LLDs, does the turbine automatically shut off if any portion of the <br />system malfunctions or fails a tightness test? <br />® <br />Li <br />ll <br />_monitoring <br />For electronic LLDs, have all accessible wiring connections been visually inspected <br />for kinks and breaks? <br />21 <br />Li <br />Li <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />21 <br />L, <br />L, <br />Were all LLDs confirmed operational within regulatory requirements? <br />R1, <br />A <br />Ll <br />LLD !D <br />LLD Model <br />Lines Monitored <br />Pass <br />Fail <br />Q1 <br />848480-001 <br />SUP. PROD. LINE <br />Q2 <br />848480-001 <br />REG. PROD. LINE <br />Q3 <br />848480-001 <br />DSL PROD. LINE <br />E7 <br />Il <br />Q <br />Di <br />Ii <br />Il <br />1:1 <br />El <br />D <br />J <br />El <br />Describe all answers marked "info" or Fail" and proposed remedy in SeC60n 9. <br />List all monitoring equipment either replaced or repaired in Section 9 <br />Page 4 of 6 <br />