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Underground Storage Tank <br /> Monitoring System Certification Form <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 /> ® 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 monitoring ® ❑ ❑ <br /> 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 /> #1-Sup P.L.L.D. Supreme N ❑ <br /> #2-Die P.L.L.D. Diesel ® ❑ <br /> #3-Reg P.L.L.D. Regular ® ❑ <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 />