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Underground Storage Tank <br /> Monitoring y t m Certification Form <br /> 7, LINE LEAK DETECTOR TESTING <br /> [7 Check this box if line leak detectors ARE NOT installed. (Do not complete this section.) <br /> Simulated release rate verified: (Check all that apply.) lies No Nil <br /> 3 GPH 0.1 GPH 0 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 ❑ <br /> alarm when a leak is detected? <br /> For mechanical LLDs, does the LLD restrict the flow through the pipe when a El 17 17 <br /> release is detected? <br /> For electronic LLD s. does the turbine autornatic:aliyr shut off when a release is <br /> detected? <br /> For electronic LLD s, does the turbine automatically shut off if any portion of the <br /> mon ito(kqg system is d is a bled o r d iscon nected? <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 LLD s, 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? ❑ <br /> Were all LLDs confirmed operational within regulatory req uirernents? � ❑ ❑ <br /> LLD ID LLD Model Lines Monitored Pass Fail <br /> T1 FXIV 87 ® ❑ <br /> T2 LD000 91T] <br /> T3 LD000 DSL [] ❑ <br /> 17 El <br /> i -- <br /> - - ❑ E❑ <br /> Describe all answer's marked Wo" or "FaX and proposed remedy in Section 9. <br /> List aff mon torft equipment either replaced or repaired in Section 9 <br /> Wage 4 of 6 <br />