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M717, E V ED <br /> Underground Storage Tank <br /> Monitoring System Certification Form � � ` �' 20 � � <br /> nU !" ,NIT R l FAIT . <br /> 7 . LINE LEAK DETECTOR TESTING <br /> ❑ 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 /> 8 3 GPH ❑ 0 . 1 GPH ❑ 0 . 2 GPH <br /> Has the testing apparatus been properly calibrated ? ❑ ❑ <br /> For emergency generator tank systems , does the LLD create an audible and visual ❑ ❑ <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 ❑ ❑ <br /> monitoring system malfunctions or fails a tightness test? <br /> For electronic LLDs , have all accessible wiring connections been visually inspected ❑ ❑ <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 /> Q - 1 P L L D - 8 4 8 4 87 PRODUCT LINE ❑ <br /> ❑ ❑ <br /> Q - 3 P L L D - 8 4 8 4 91 PRODUCT LINE ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <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 />