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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 7. LINE LEAK DETECTOR TESTING <br /> ❑ Check this box if line Ieak detectors ARE NOT installed. (Do not complete this section.) <br /> Simulated release rate verified: (Check all that apply.) Yes No NA <br /> A 3 GPH ❑ 0.1 GPH ❑ 0.2 GPH <br /> Has the testing apparatus been properly calibrated? A J J <br /> For emergency generator tank systems, does the LLD create an audible and visual D D R) <br /> alarm when a leak is detected? <br /> For mechanical LLDs, does the LLD restrict the flow through the pipe when a ❑ Lj <br /> release is detected? <br /> For electronic LLDs, does the turbine automatically shut off when a release is 21 Ll ❑ <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 0 J ❑ <br /> monitoring system malfunctions or fails a tightness test? <br /> For electronic LLDs, have all accessible wiring connections been visually inspected 23 ❑ ❑ <br /> for kinks and breaks? <br /> Were all items an the equipment manufacturer's maintenance checklist completed? A L] ❑ <br /> Were all LLDs confirmed operational within regulatory requirements? <br /> LLD ID LLD Morel Limes Monitored Pass Fail <br /> Q1 848480-001 REG.-A-PROD. LINE R1 Lj <br /> Q2 848480-001 REG.-B-PROD. LINE ❑ <br /> Q3 848480-001 DSL PROD. LINE ® ❑ <br /> Q5 848480-001 PREM. -A-PROD. LINE Q ❑ <br /> Q6 848480-001 PREM. -B-PROD. LINE ® ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ D <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> Q Q <br /> Describe all answers marked "No"or `Fail"and proposed remedy in Secrlon 9. <br /> List all monitoring equipment either replaced or repaired in Section 9 <br /> Page 4 of 6 <br />