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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 7. LINE LEAK DETE TOR TESTING <br /> ❑Check this box if lin leak detectors ARE NOT installed. (Do not complete this section.) <br /> Simulated release rat verified: (Check all that apply.) Yes No NA <br /> x3 GPH 00.1 GPH❑ .2 GPH <br /> Has the testing apparatus been properly calibrated? x ❑ ❑ <br /> For emergency generator tank systems, does the LLD create an audible and visual alarm O ❑ x <br /> when a leak is detect d? <br /> For mechanical LLDs, does the LLD restrict the flow through the pipe when a release is ❑ X <br /> detected? <br /> For electronic LLDs, c oes the turbine automatically shut off when a release is detected? X ❑ <br /> For electronic LLDs, c oes the turbine automatically shut off if any portion of the monitoring X ❑ <br /> system is disabled or isconnected? <br /> For electronic LLDs, c oes the turbine automatically shut off if any portion of the monitoring X ❑ <br /> system malfunctions or fails a tightness test? <br /> For electronic LLDs, ave all accessible wiring connections been visually inspected for X ❑ <br /> kinks and breaks? <br /> Were all items on the equipment manufacturer's maintenance checklist completed? x ❑ ❑ <br /> Were all LLDs confirmed operational within regulatory requirements? x ❑ ❑ <br /> LLD ID L D Model Lines Monitored Pass Fail <br /> Q1 V/R 84E 4 87 X ❑ <br /> Q2 V/R 84E 4 91 X ❑ <br /> Q3 V/R 84E 4 DIESEL X ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> Describe all answe s 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 />