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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 7. UNE LEAK DETECTOR TESTING <br /> ❑ Check this box if line leak detectors ARE NOT installed. (Do not complete thissection.) <br /> Simulated release rate verified: (Check all that apply.) Yes No NA <br /> 0 3 GPH ❑ 0.1 GPH 0 0.2 GPH <br /> Has the testing apparatus been properly calibrated' ® ❑ ❑ <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. ❑ ❑ 0 <br /> release is detected? <br /> For electronic LLDs, does the turbine automatically shut off when a release is 0 0 ❑ <br /> detected? <br /> For electronic LLDs., does the turbine automatically shut off if any portion of the ❑ ❑ <br /> rnonitorin system is disabled or disconnected'? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the ® ❑ 0 <br /> monitori ng system maIfunGtions or fails a tig htness test? <br /> For electronic LLDs, have all accessible wiring connections been visually inspected ® 13 0 <br /> for kinks and breaks? <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 Modeq Lines Monitored Pass Fern <br /> Q1 VR PLLD Diesel 0 ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ c� <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> Describe all answers marked 'No" or "nail" and proposed remedy in Section 9, <br /> List ail monitoring equipment either replaced or repaired in Section 9 <br /> Page 4of6 <br />