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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 7. Llly LEAK DETECTOR TESTING - <br /> (� Check this box if line Ieak detectors ARE NOT installed. Do not complete this section. <br /> Si ;3G:P <br /> ed release rate verified: {Check all that apply.} JYes ` No PIA <br /> H 0.1 GPH __.._.� 0.2 GPH <br /> Has the testing apparatus been properly calibrated? ® ` F <br /> _-..-_.._........... ._......._ --- . <br /> --___.................._..______-__........... _._.... .............. <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? <br /> For electronic LLDs. does the turbine automatically shut off when a release is <br /> detected? _ <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the <br /> monitoring system is disabled or disconnected?For electronic LLDs, does the turbine automatically shut off if an—y portion of the � <br /> monitoring system malfunctions or fails a tightness test? <br /> . . ...........__........_........-._ ..._ <br /> or electronic LLDs, have all acces nn <br /> sible wiring coections b_-e e n visually inspected ............... <br /> _ <br /> for kinks and breaks? F I R7 C <br /> _ _..__......._ <br /> Were all items on the equipment manufacturer's maintenance checklist completed? <br /> Were all LLDs confirmed operational within regulatory requirements? Q J <br /> — - ------ --— _ _..................... <br /> LLD ID LLD Model Lines Monitored Pass Fail <br /> T# 1 PLLD regular <br /> __......� __..._.._._._-_--_.._....__.__...__._...................._....____ <br /> T# 2 PLLD super07 <br /> El <br /> 1 17 T7 <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 />