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UNDERGROUND STORAGE TANK <br />MONITORING SYSTEM CERTIFICATION' FORM (Page 5 of 6) <br />XVI. LINE LEAK DETECTOR TESTING <br />GPH =Gallons per hour, Y = Yes, N = No, NA Not <br />r Check this box if line leak detectors (LLD) are NOT installed. (Do not complete this section.) <br />This section must be completed if LLDs are installed. <br />Y <br />N <br />NA <br />Was a leak simulated to verify LLD performance? <br />Check all that apply.) Simulated leak rate verified: r' 3 GPG r 1.1 GPG r 0.2 GPH <br />Was the testing apparatus properly calibrated? <br />r <br />r <br />r <br />r <br />r <br />r <br />For emergency generator tank systems, does the LLD create an audible and visual alarm when a leak is detected? <br />r <br />r <br />r <br />For mechanical LLDs, does the LLD restrict the flow through the pipe when a leak is detected? <br />F <br />r <br />r <br />For electronic LLDs, does the turbine automatically shut off when a leak is detected? <br />r <br />r <br />r <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br />r <br />r <br />r <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br />r <br />r <br />r <br />For electronic LLDs, have all accessible wiring connections been visually inspected for kinks and breaks? <br />r <br />r <br />F <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />r <br />r <br />r <br />Were all LLDs confirmed operational within regulatory requirements? <br />r <br />r <br />r <br />For any answer of 'W" above, describe in section X111 how and when these issues were or <br />will be corrected. <br />XIII. COMMENTS <br />XIV. VACUUM t PRESSURE/ HYDROSTATIC <br />MONITORING <br />EQUIPMENT TESTING <br />F Check this box if VPH monitoring is NOT used. (Do not complete this section.) <br />This section must be completed if VPH monitoring is used to perform leak detection monitoring. <br />System Type (Mark all that apply,) F Vacuum r Pressure r H drostatic <br />Sensor ID <br />Component(s) Monitored, by this Sensor <br />Sensor Functionality <br />Test <br />Interstitial <br />Communication <br />Test <br />S9 <br />87 PROD. LINE <br />F Pass r Fail <br />r Pass <br />r <br />Fail <br />S10 <br />87 STP/ FILL LINE. <br />F Pass r Fail <br />F Pass <br />r <br />Fail <br />S11 <br />87 VAPOR UDC'S LINE <br />F Pass r Fail <br />F Pass <br />r <br />Fail <br />S12 <br />91 PROD, LINE <br />F Pass r Fail <br />F Pass <br />r <br />Fail <br />S13 <br />91 STP/FILL SUMPS <br />F Pass r Fail <br />F Pass <br />r <br />Fail <br />S14 <br />87/91 VENT LINE. <br />r Pass r Fail <br />r Pass <br />r <br />Fail <br />S15 <br />DSL PROD. LINE <br />F Pass r Fail <br />F Pass <br />r <br />Fail <br />S16 <br />DSL STP/FILL SUMPS <br />F Pass r Fail <br />r Pass <br />r <br />Fail <br />S17 <br />DSL VENT LINES <br />r Pass r Fail <br />F Pass <br />r <br />Fail <br />r Pass r Fail <br />r Pass <br />r <br />Fail <br />r Pass r Fail <br />r Pass <br />r <br />Fail <br />r Pass r Fail <br />r Pass <br />r <br />Fail <br />How was interstitial communication verified? F Simulated leak at far ends of the interstitial space. <br />F Other Describe the method in section XV below. <br />r <br />r <br />Visual Inspection <br />Gauge <br />Was the vacuum or pressure restored to operating levels in all interstitial spaces? F Yes r No (Describe the reason <br />in section XV below.) <br />For any answer of "N" above, describe in section XIII how and when these issues were or <br />will be corrected. <br />XV. COMMENTS <br />applicable, VPH =Vacuum/Pressure/Hydrostatic, ID =Identification <br />