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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 release rate verified: (Check all that apply.) N 3 GPH ❑ 0.1 GPH ❑ 0.2 GPH Yes No NA Has the testing apparatus been properly calibrated? N ❑ ❑ For emergency generator tank systems, does the LLD create an audible and visual alarm when a leak is detected? ❑ ❑ N For mechanical LLDs, does the LLD restrict the flow through the pipe when a release is detected? N ❑ ❑ For electronic LLDs, does the turbine automatically shut off when a release is detected? ❑ ❑ N For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? ❑ ❑ N For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or falls a tightness test? ❑ ❑ N For electronic LLDs, have all accessible wiring connections been visually inspected for kinks and breaks? ❑ ❑ N Were all items on the equipment manufacturer's maintenance checklist completed? ® ❑ ❑ Were all LLDs confirmed operational within regulatory requirements? N ❑ L ❑ LLD ID LLD Model Lines Monitored Pass Fail T-1 87 Fe -Petro MLD -STP T-1 87 Product Line SN#04080026 N ❑ T-2 Diesel VMI LD -2000 T-2 Diesel Product Line SN#08031181 N ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 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 4 of 6