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Underground Storage Tanis <br /> Monitoring System Certification Form <br /> 7. LINC LiAK DETECTOR TESTING - -- -- �AW <br /> Lr heok 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 N <br /> 3 GPH 0 0.1 GPH 17 0.2 CPH <br /> Has the testing apparatus been properly calibrated? ❑ ❑ ❑ <br /> For emergency generator tank systems, does the LLD create an audible and visual ❑ ❑ E <br /> alarm when a leak is detected? <br /> For mechanical LLDs, does the LLD restrict the flow through the pipe when a ❑ ❑ <br /> 17 <br /> release is detected' <br /> For electronic L LDs, does the turbine automatically shut off when a release is Q ❑ ❑ <br /> detected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the El El El <br /> system is disabled or disconnected' <br /> For electronic LLDs. does the turbine automatically shut off if any portion of the El El ❑ <br /> monitoringsystem malfunctions or fails a tightness test? <br /> Far electronic LLDs, have all accessible wiring ccnnections been visuaIly inspected El <br /> ❑ <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 requirements"? ❑ E] <br /> LLD OD LLD Mode✓' _ Lines Monitored _ Pass Fail <br /> T11 F 1DV DSL I IIJ ❑ <br /> T2 FXIDV D L 2 ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> Describe all answers marked "No"or`Fair'and proposed remedy in Section 9, <br /> List all monitoring equipment either replaced or repaired in Section 9 <br /> Page 4 of 6 <br />