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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 /> 0 3 GPH 0 0.1 GPH [M 0.2 GPH <br /> Has the testing apparatus been properly calibrated? © 0 <br /> For emergency generator tank systems, does the LLD create an audible and visual rl I ✓0 <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? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the 0 <br /> monitoring system malfunctions or fails a tightness test? <br /> For electronic LLDs, have all accessible wiring connections been visually inspected 0 In 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 Model Lines Monitored Pass Fail <br /> Q1 VR 859080-001 87 plld ❑✓ El <br /> Q2 VR 859080-001 91 plld 0 FEI <br /> Q3 VR 859080-001 diesel plld © M <br /> 0 ❑ <br /> 0 ❑ <br /> © ❑ <br /> rl ❑ <br /> ® ❑ <br /> © ❑ <br /> © ❑ <br /> 0 ❑ <br /> 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 />