COMPLIANCE INFO_2021 - Laserfiche WebLink

Home Browse Search

UNDERGROUND STORAGE TANK MONITORING SYSTEM CERTIFICATION FORM (Page 5 of 6) I XII. LINE LEAK DETECTOR TESTING Check this box if line leak detectors (LLD) are NOT installed. (Do not complete this section.) must be completed if LLDs are installed. Y N NA This section Was a leak simulated (Check all that to verify LLD performance? • MI apply.) Simulated leak rate verified: 0 3 GPH • 0.1 GPH • 0.2 GPH Was the testing apparatus properly calibrated? II NI For emergency generator tank systems, does the LLD create an audible and visual alarm when a leak is detected? IN II For mechanical LLDs, does the LLD restrict the flow through the pipe when a leak is detected? • • For electronic LLDs, does the turbine automatically shut off when a leak is detected? II • El For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? M II For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? MI II A For electronic LLDs, have all accessible wiring connections been visually inspected for kinks and breaks? II • & Were all items on the equipment manufacturer's maintenance checklist completed? • M Were all LLDs confirmed operational within regulatory requirements? 01 • MI For any answer of "N" above, describe in section XIII how and when these issues were or will be corrected. XIII. COMMENTS XIV. VACUUM / PRESSURE/ HYDROSTATIC MONITORING EQUIPMENT TESTING Check this box if VPH monitoring is NOT used. (Do not complete this section.) must be completed if VPH monitoring is used to perform leak detection monitoring. This section System Type (Mark all that apply.) II Vacuum M Pressure • Hydrostatic Sensor ID Component(s) Monitored by this Sensor Sensor Functionality Test Interstitial Communication Test Pass • Fail M Pass III Fail M Pass • Fail U Pass II Fail Pass II Fail M Pass • Fail M Pass M Fail Pass • Fail Pass MI Fail II Pass • Fail Pass III Fail Pass M Fail MI Pass • Fail Pass MI Fail II Pass • Fail Pass • Fail Pass SI Fail U Pass IN Fail II Pass II Fail 0 Pass II Fail IN Pass • Fail IN Pass • Fail Pass • Fail Pass • Fail How was interstitial II Simulated leak at far ends of the interstitial space. II Visual Inspection communication verified? II Other (Describe the method in section XV below.) Gauge Was the vacuum or pressure restored to operating levels in all interstitial spaces? II 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 = Vacuurn/Presswelflydrostatic, ID = Identification