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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 7. LINE LEAK DETECTOR TESTING <br /> �I 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 /> R) 3 GPH LJ 0.1 GPH LJ 0.2 GPH <br /> Has the testing apparatus been properly calibrated? 0 J J <br /> For emergency generator tank systems, does the LLD create an audible and visual J Ll <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 0, ❑ ❑ <br /> detected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the 0 LJ ❑ <br /> monitoring system is disabled or disconnected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the A ❑ ❑ <br /> monitoring system malfunctions or fails a tightness test? <br /> For electronic LLDs, have all accessible wiring connections been visually inspected j ❑ ❑ <br /> for kinks and breaks? <br /> Were all items on the equipment manufacturer's maintenance checklist completed? 0 ❑ ❑ <br /> Were all LLDs confirmed operational within regulatory requirements? <br /> LLD ID LLD Model Lines Monitored Pass Fail <br /> Q1 REG. PROD. LINE [� <br /> Q3 PREM. PROD. LINE B <br /> Q4 DSL PROD. LINE ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> 13 D <br /> n <br /> -ul <br /> Ll C_f <br /> ❑ <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 />