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Underground Storage Tank <br />Release Detection Equipment Testing Report Form <br />7. LINE LEAK DETECTOR TEST RESULTS <br />❑ Check this box if line leak detectors ARE NOT installed. (Do not complete this section.) <br />❑ Check this box if Appendix 5.2 continuation page is attached. <br />Simulated release rate verified: (Check all that apply.) <br />0 3 GPH ❑ 0.1 GPH (Required only if LLD performs line tightness testing) <br />Yes <br />No <br />NA <br />Has the testing equipment been properly calibrated? <br />p <br />❑ <br />❑ <br />For emergency tank systems, does the LLD create an audible and visual alarm <br />when a release is detected? <br />❑ <br />❑ <br />0 <br />For mechanical LLDs, does the LLD restrict the flow through the pipe when a <br />release is detected? <br />0 <br />❑ <br />❑ <br />For electronic LLDs, does the pressure supply pump automatically shut off when <br />a release is detected? <br />❑ <br />❑ <br />0 <br />For electronic LLDs, does the pressure supply pump automatically shut off if the <br />monitoring system or LLD is disabled or disconnected? <br />❑ <br />❑ <br />0 <br />For electronic LLDs, does the pressure supply pump automatically shut off if the <br />monitoring system or LLD malfunctions or fails a tightness test? <br />❑ <br />❑ <br />0 <br />For electronic LLDs, have all accessible wiring connections been visually <br />inspected for kinks and breaks? <br />❑ <br />❑ <br />0 <br />Were all items on the equipment manufacturer's maintenance checklist <br />completed? <br />0 <br />❑ <br />❑ <br />Were all LLDs confirmed operational within regulatory requirements? <br />p <br />❑ <br />❑ <br />List only line leak detectors tested. <br />LLD ID <br />LLD Model <br />Lines Monitored <br />Pass <br />Fail <br />87 <br />99LD2000 <br />87 LINES <br />p <br />❑ <br />91 <br />99LD2000 <br />91 LINES <br />0 <br />❑ <br />DSL <br />99LD2000 <br />DSL LINES <br />p <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />Describe all answers marked "No" or "Fail" and the proposed remedy in Section 8. <br />List all equipment either replaced or repaired (including cleaning or adjustment) in Section 8. <br />Page 4of6 <br />