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Underground Storage Tank Release Detection Equipment Testing Report Form 7. LINE LEAK DETECTOR TEST RESULTS ❑ Check this box if line leak detectors ARE NOT installed. (Do not complete this section.) Check this box if Appendix 5.2 continuation page is attached. Simulated release rate verified: (Check all that apply.) Yes No NA Z 3 GPH ❑ 0.1 GPH 'Required only if LLD perfbnns fine tightness testin Has the testing equipment been properly calibrated? 0 ❑ ❑ For emergency tank systems, does the LLD create an audible and visual alarm ❑ ❑ when a release is detected? For mechanical LLDs, does the LLD restrict the flow through the pipe when a ❑ ❑ Z release is detected? For electronic LLDs, does the pressure supply pump automatically shut off when ❑ ❑ a release is detected? For electronic LLDs, does the pressure supply pump automatically shut off if the ❑ ❑ monitoring system or LLD is disabled or disconnected? For electronic LLDs, does the pressure supply pump automatically shut off if the LJ ❑ monitoring system or LLD malfunctions or fails a tightness test? For electronic LLDs, have all accessible wiring connections been visually z L2 ❑ inspected for kinks and breaks? Were all items on the equipment manufacturer's maintenance checklist 0 ❑ ❑ completed? Were all LLDs confirmed operational within regulatory requirements? ❑ ❑ ❑ List only lure leak detectors tested. LLD IO LLD Model Lines Monitored Pass Fail Q1 848480-001 SUP. PROD. LINE 7 ❑ Q2 848480-001 REG. PROD. LINE ❑ ❑ Q3 848480-001 DSL PROD. LINE 0 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Describe all answers marked 'No" or "Fail"and the proposed remedy in Section S. List ail equipment either replaced or repaired (including cleaning or adjustment) in Section B. Page 4 of 6