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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 /> R1 3 GPH El 0-1 GPH ❑ d-2 GPH <br /> Has the testing apparatus been properly calibrated? 0 ❑ ❑ <br /> For emergency generator tank systems, does the LLD create an audible and visual ❑ ❑ 0 <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 ❑ ❑ 0 <br /> detected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the <br /> monitoring system is disabled or disconnected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the ❑ ❑ <br /> monitoTina s stem malfunctions orfails a tightness test? <br /> For electronic LLDs, have all accessible wiring connections been visually inspected ❑ ❑ 11 <br /> for kinks and breaks? <br /> Were all items on the equipment manufacturer's maintenance checklist crompleted? ® ❑ ❑ <br /> Were all LLDs confirmed operational within regulatory requirements? ❑ ❑ <br /> LLD 1D. LLD Model Limes Monitored Pass Fail <br /> T3 Vaporless LD-2000 RUL 87 A ❑ <br /> T4 Vaporless LD-2000 PUL 91 A ❑ <br /> T5 Vapodess LD-2000 DIESEL ❑ <br /> ❑ ❑ <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 4of6 <br />