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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 7. LINE LEAK DETECTOR TESTING <br /> C 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 /> 3 GPH M 0.1 GPH Ej 0.2 GPH <br /> Has the testing apparatus been properly calibrated? M M M <br /> For emergency generator tank systems, does the LLD create an audible and visual M <br /> El Ej <br /> alarm when a leak is detected? <br /> For mechanical LLDs, does the LLD restrict the flow through the pipe when a M <br /> 0 El <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? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the ® ® M <br /> monitoring system malfunctions or fails a tightness test? <br /> For electronic LLDs, have all accessible wiring connections been visually inspected <br /> for kinks and breaks? _ <br /> Were all items on the equipment manufacturer's maintenance checklist completed? ® l� <br /> Were all LLDs confirmed operational within regulatory requirements? ri M <br /> LLD ID LLD Model Lines Monitored Pass Fail <br /> T1-87 VM12000 87 Tank#1 M El <br /> M El <br /> El El ED <br /> El El <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 />