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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 /> Ej 3 GPH In 0.1 GPH r] 0.2 GPH <br /> Has the testing apparatus been properly calibrated? ® E3 11 <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 11 13 El <br /> release is detected? <br /> For electronic LLDs, does the turbine automatically shut off when a release is E3 r3 r3 <br /> detected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the E3 U 07 <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 <br /> for kinks and breaks? <br /> Were all items on the equipment manufacturer's maintenance checklist completed? <br /> Were all LLDs confirmed operational within regulatory requirements? 1 F3 1 C3C <br /> LLD ID LLD Model Lines Monitored Pass Fail <br /> Q2 Veeder-Root PLLD Diesel Line 2 <br /> 13 El <br /> ri E31 <br /> r <br /> 0 El <br /> 11 E3 <br /> r] r] <br /> E3 El <br /> El E3 <br /> C El <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 />