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Underground Storage Tank <br /> Release Detection Equipment Testing Report Form <br /> :.. . ............. <br /> . . ............ <br /> '7. LINE LEAiFC DETEGTDR TEST RESULT <br /> ❑ Check this box if line leak detectors ARE NOT installed. (Do not complete this section_) <br /> ❑ Check this box if Appendix 5.2 continuation page is attached. <br /> Simulated release rate verified: (Check all that apply.) <br /> ❑ 3 GPH ❑0.1 GPH (Required Only if LLD performs line tightness testing) <br /> Has the testing equipment been properly calibrated? ❑ ❑ ❑ <br /> For emergency tank systems, dqes the LLD create an audible nd visual alarm <br /> when a release is detected? ❑ ❑ ❑ <br /> For mechanical LLDs, does the LL restrict the flow through he pipe when a <br /> release is detected? ❑ ❑ ❑ <br /> For electronic LLDs, does the pressure pply pump auto atically shut off when <br /> a release is detected? ❑ ❑ ❑ <br /> For electronic LLDs, does the pressure sup pump a omatically shut off if the <br /> monitorings stem or LLD is disabled or disco nected ❑ ❑ ❑ <br /> For electronic LLDs, dues the pressure supply ump utomatically shut off if the <br /> monitorin s stem or LLD malfunctions or fails a tness test? ❑ ❑ ❑ <br /> For electronic LLDs, have all accessible wiring co ections been visually <br /> ins ected for kinks and breaks? ❑ ❑ ❑ <br /> Were all items on the equipment manufacturer' main nance checklist <br /> completed? ❑ ❑ ❑ <br /> Were all LLDs confirmed operational within Aulatory re irements? ❑ ❑ ❑ <br /> List only line leak detectors tested. <br /> LLD ID LLD Model Lines nitored Pass` `'"fail <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ El <br /> ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> Describe all answers marked "No"or"Fail"and the proposed remedy in Section B. <br /> List all equipment either replaced or repaired (including cleaning or adjustment) in Section 8. <br /> Page 4 of 6 <br />