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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 Appen 'x 5.2 continuation page is attached. <br />Simulated release rate verifi d: {Check all that apply.} <br />❑ 3 GPH ❑ D.1 GPH ( equired onl if LLD performs line fighfnes testing) <br />Yes <br />No <br />NA <br />Has the testing equipment been roperly calibrated? <br />❑ <br />❑ <br />❑ <br />For emergency tank systems, do the LLD create an audible a visual alarm <br />when a release is detected? <br />❑ <br />❑ <br />❑ <br />For mechanical LLDs, does the LLD estrict the flow throug the pipe when a <br />release is. detected? <br />❑ <br />❑ <br />❑ <br />For electronic LLDs, does the pressure supply pump a omatically shut off when <br />a release is detected? <br />El <br />❑ <br />❑ <br />y pu automatically shut off if the <br />For electronic LLDs, does the pressureAdisponn <br />monitoringsystem or LLD is disabled octed? <br />❑ <br />❑ <br />❑ <br />For electronic LLDs, does the pressure supe ump automatically shut off if the <br />monitoringsystem or LLD malfunctions or fa' s tightness test? <br />❑ <br />❑ <br />❑ <br />For electronic LLDs, have all accessible w' ing c nnections been visually <br />inspected for kinks and breaks? <br />❑ <br />❑ <br />❑ <br />Were all items on the equipment man cturer's ma' tenance checklist <br />completed? <br />❑ <br />❑ <br />Were all LLDs confirmed ope ratioI within regulatory r uirements? <br />❑ <br />❑ <br />❑ <br />List only line leak defectors tes d. <br />LLD ID <br />LLD Mode <br />Lines Mbnitored <br />Pass <br />Fail <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />Describe all answers marked "No" or "Fail" and the proposed remedy in Section B. <br />List all equipment either replaced or repaired (including cleaning or adjustment) in Section 8, <br />Page 4 of 6 <br />