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Underground Storage Tank <br />Monitoring System Certification Form <br />7. LINE LEAK DETECTOR TESTING <br />SI Check this box if line leak detectors ARE NOT installed. (Do not complete this section.) <br />Simulated release <br />3 GPH <br />rate verified: (Check all that apply.) <br />0.2 GPH Yes No NA IN 0.1 GPH El <br />Has the testing apparatus been properly calibrated? • • M <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? o El • <br />For electronic LLDs, does the turbine automatically shut off when a release is <br />detected? El El • <br />For electronic LLDs, does the turbine automatically shut off if any portion of the <br />monitoring system is disabled or disconnected? El El • <br />For electronic LLDs, does the turbine automatically shut off if any portion of the <br />monitoring system malfunctions or fails a tightness test? El NI <br />For electronic LLDs, have all accessible wiring connections been visually inspected <br />for kinks and breaks? El • <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />Were all LLDs confirmed operational within regulatory requirements? <br />LLD ID LLD Model Lines Monitored Pass Fail <br />DO <br />• • <br />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