COMPLIANCE INFO_2019 - Laserfiche WebLink

Home Browse Search

f , I UNDERGROUND STORAGE TANK MONITORING SYSTEM CERTIFICATION FORM (Page 5 of 6) XII . LINE LEAK DETECTOR TESTING ❑ Checkthis box if line leak detectors (LLD) are NOT installed . (Do not complete this section.) Y FN NA This section must be completed if LLDs are installed. Was a leak simulated to verify LLD performance? ❑ ❑ ❑ (Check all that apply) Simulated leak rate verified : 0 3 GPH El 0. 1 GPH ❑ 0.2 GPH Was the testing apparatus properly calibrated? 0 ❑ ❑ For emergency generator tank systems , does the LLD create an audible and visual alarm when a leak is detected? ❑ ❑ 0 For mechanical LLDs , does the LLD restrict the flow through the pipe when a leak is detected? Q ❑ ❑ For electronic LLDs , does the turbine automatically shut off when a leak is detected? ❑ Q For electronic LLDs , does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected ? ❑ ❑ Q For electronic LLDs , does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? ❑ ❑ 0 For electronic LLDs , have all accessible wiring connections been visually inspected for kinks and breaks? ❑ ❑ 0 Were all items on the equipment manufacturer's maintenance checklist completed ? Q ❑ ❑ Were all LLDs confirmed operational within regulatory requirements? Q ❑ ❑ For any answer of "M' above, describe in Section Xlll how and when these issues were or will be corrected. XIII . COMMENTS replaced 91 Id and adjusted 876 XIV. VACUUM / PRESSURE / HYDROSTATIC MONITORING EQUIPMENT TESTING QX Check this box if VPH monitoring is NOT used . (Do not complete this section) This section must be completed if VPH monitoring is used to perform leak detection monitoring. System Type (Mark all that apply.) ❑ Vacuum ❑ Pressure ❑ Hydrostatic Sensor ID Component(S) Monitored By This Sensor Sensor Functionality Interstitial Communication Test Test ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail How was interstitial communication verified? ❑ Simulated Leak at Far Ends of the Interstitial Space ❑ Visual Inspection ❑ Other (Describe the method in section XV below.) ❑ Gauge Was the vacuum or pressure restored to operating levels in all interstitial spaces? ❑ Yes ❑ No (Describe the reason in section XV below.) For any answer of "Fail" above, describe in Section XV how and when these issues were or will be corrected. XV. COMMENTS GPH = Gallons Per Hour, Y = Yes, N = No, NA = Not Applicable, VPH = Vacuum/Pressure/Hydrostatic, ID = Identification