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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 7. LINE LEAK DETECTOR TESTING <br /> C 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 /> F] 3 GPH ❑Ir 0.1 GPH © 0.2 GPH <br /> Has the testing apparatus been properly calibrated? r FEI El <br /> For emergency generator tank systems, does the LLD create an audible and visual FEI El El <br /> alarm when a leak is detected? <br /> For mechanical LLDs, does the LLD restrict the flow through the pipe when a F <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? F © ❑I� <br /> Were all LLDs confirmed operational within regulatory requirements? <br /> LLD ID LLD Model Lines Monitored Pass Fail <br /> T1 FX1V T1 Diesel �✓ 0 <br /> T2 99 LD-2000 T2 Diesel ✓0 <br /> T3 99 LD-2000 T3 Diesel ✓0 <br /> T6 FX1V AUTO DSL 0✓ <br /> © a <br /> © o <br /> o r] <br /> 0 0 <br /> El El <br /> 0 0 <br /> 0 0 <br /> o <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 />