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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 /> Q 3 GPH 0 0.1 GPH 0 0.2 GPH <br /> Has the testing apparatus been properly calibrated? El 0 0 <br /> For emergency generator tank systems, does the LLD create an audible and visual 0 0 E <br /> alarm when a leak is detected? <br /> For mechanical LLDs, does the LLD restrict the flow through the pipe when a 0 0 El <br /> release is detected? <br /> For electronic LLDs, does the turbine automatically shut off when a release is 0 I 0 <br /> detected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the M © 0 <br /> monitoring system is disabled or disconnected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the 1 f © 0 <br /> monitoring system malfunctions or fails a tightness test? <br /> For electronic LLDs, have all accessible wiring connections been visually inspected E- 0 0 <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? 0 <br /> LLD ID LLD Model Lines Monitored Pass Fail <br /> Q-2 PLLD 8484 87 Product Line <br /> Q-3 PLLD 8484 91 Product Line R I <br /> El El <br /> 0 � <br /> © 0 <br /> 0 <br /> In 0 <br /> © 0 <br /> a 0 <br /> © D <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 />