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Underground Storage Tank Release Detection Equipment Testing Report Form 7. LINE LEAK DETECTOR TEST RESULTS ❑ Check this box €f line leak detectors ARE NOT installed. (Do not complete this section.) ❑ Check this box if Appendix 5.2 continuation page is attached. Simulated release rate verified: (Check all that apply.) V 3 GPH ❑ 0.1 GPH wired only if LLD performs line ti htness festin Yes No NA Has the testing equipment been properly calibrated? 0 ❑ ❑ For emergency tank systems, does the LLD create an audible and visual alarm when a release is detected? ❑ ❑ V For mechanical LLDs, does the LLD restrict the flow through the pipe when a release is detected? ❑ ❑ 0 For electronic LLDs, does the pressure supply pump automatically shut off when a release is detected? ❑ ❑ For electronic LLDs, does the pressure supply pump automatically shut off if the monitoring system or LLD is disabled or disconnected? 0 ❑ ❑ For electronic LLDs, does the pressure supply pump automatically shut oft if the monitoring system or LLD malfunctions or fails a tightness test? Z ❑ ❑ For electronic LLDs, have all accessible wiring connections been visually ins cted for kinks and breaks? Z ❑ ❑ Were all iterns on the equipment manufacturer's maintenance checklist completed? 0 ❑ ❑ Were all LLDs confirmed operational within regulatory requirements? ❑ ❑ List only fine leak defectors tester!. LLD ID LLD Model Lines Monitored 91 PROD. LINE Pass Fall Q1 848480-001 Q2 848480-001 87 PROD. LINE DSL PROD. LINE ❑ Q3 848480-001 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Describe all answers marked "No" or "Fad" and the proposed remedy in Section 8. List ail equipment either replaced or repaired fin cfuding cleaning or adjustment) in Section 8. Page 4 of 6