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Underground Storage Tank <br />Monitoring System Certification Form <br />7. LINE LF -AK DETECTOR TESTING <br />❑ Dheck this box if line leak detectors ARE NOT installed. (Do not complete this section] <br />Simulated release rate verified: {Check all that apply.) <br />E 3 GPH ❑ 01 GPH ❑ 0,2 GPH <br />lies <br />No <br />ISA <br />Has the testing apparatus been properly catibrated? <br />N <br />❑ <br />❑ <br />For emergency generator tank systems, does the LLD create an audible and visual <br />alarm when a leak is detected' <br />O <br />D <br />N <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 />® <br />� <br />❑ <br />❑ <br />For electronic LLD, does the turbine automatically shut off if any portion of the <br />monitoring system is disabled or disconnected? <br />❑ <br />❑ <br />For electronic LLDs, does the turbine automatically shut off if any portion of the <br />monitoring system malfunctions or fails a tightness test? <br />❑ <br />❑ <br />Far electronic LLDs, have all accessible vViring connections been visually inspected <br />for kinks and Freaks? <br />❑ <br />❑ <br />0 <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />® <br />❑ <br />0 <br />Were all LLDs confirmed operational within regulatory requirements? <br />❑ <br />❑ <br />LLD ID <br />LLD Model <br />Lines Mont and <br />Pass <br />N <br />Fart <br />0 <br />I <br />VI II LD 2000 Regular <br />VMI LD 2000 Premium <br />2 <br />0 <br />❑ <br />❑ <br />3 <br />TIMI LD 2000 <br />' Diesel <br />- <br />❑ <br />❑ <br />D <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />01 <br />11 <br />❑ <br />❑ <br />Describe all answers marked "No " or "Fail" ar,d proposed rem ody in Section 9 - <br />List all monitoring equipment either replaced or repaired in Section <br />Page 4 of <br />