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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 /> Sim�u/lpted release rate verified : (Check all that apply. ) Yes No ` NA <br /> 1(Z 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 ® El <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 ❑ ❑ <br /> monitoring 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 ? rE03 Were all LLDs confirmed operational within regulatory requirements? ❑ <br /> LLD ID LLD Model Lines Monitored Pass Fail <br /> P �ucyre` r � � �NL ,� ❑ <br /> r� sA � a I � w� ❑ <br /> ❑ ❑ <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 4 of 6 <br />