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Underground Storage Tank <br /> Monitoring System Certification Farm <br /> 1. 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 /> 0 3 GPH LJ 0.1 GPH LI 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 Li Li 0 <br /> alarm when a leak is detected? <br /> For mechanical LLDs, does the LLD restrict the flow through the pipe when a Li Li <br /> release is detected? <br /> For electronic LLDs, does the turbine automatically shut off when a release is ® J EJ <br /> detected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the A LI LI <br /> monitoring system is disabled or disconnected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the ® LI LI <br /> monitorinq system malfunctions or fails a tightness test? <br /> For electronic LLDs, have all accessible wiring connections been visually inspected ® Li LI <br /> for kinks and breaks? <br /> Were all items on the equipment manufactures maintenance checklist completed? ® El El <br /> Were all LLDs confirmed operational within regulatory requirements? D <br /> LLD ID LLD Madel Lines Monitored Pass Fail <br /> Q1 848480-001 Supreme Id LI <br /> Q2 848480-001 Regular Id LI <br /> Q3 848480-001 Dsl ® L1 <br /> El L1 <br /> LI El <br /> I El <br /> LI LI <br /> LI LI <br /> ij LI <br /> Describe all answers marked "No"or"Fail'and proposed remedy in Section 9. <br /> List all monitoring equipment either replaced or repaired lir Section 9 <br /> Page 4 of 6 <br />