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Underground Storage Tank Monitoring System Certification Form 7. LINE LEAK DETECTOR TESTING ❑ Check this box if line leak detectors ARE NOT installed. (Do not complete this section.) Simulated rate verified: (Check all that apply) ®3 GPH ❑ 0.1 GPH ❑ 0.2GPH Yes No NA Has the testing apparatus been properly calibrated? ® ❑ ❑ For emergency generator tank systems, does the LLD create an audible and visual alarm when a leak is detected? ❑ ❑ For mechanical LLDs, does the LLD restrict the flow through the pipe when a release is detected? ® ❑ ❑ For electronic LLDs, does the turbine automatically shut off when a leak is detected? ❑ ❑ For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? ❑ ❑ For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a tightness test? ❑ ❑ For electronic LLDs, have all accessible wiring connections been visually inspected for kinks and breaks? ❑ ❑ Were all items on the equipment manufacturer's maintenance checklist completed? ® ❑ ❑ Were all LLDs confirmed operational within regulatory requirements? ® ❑ ❑ LLD ID LLD Model Lines Monitored Pass Fail 91 LD2000 91 ® ❑ 87 Red Jacket 87 ® ❑ DSL Red Jacket DSL ® ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Describe all answers marked "No" or "Fail" and proposed remedy in Section 9. List all Monitoring equipment either replaced or repaired in Section 9. Page 6 of 9