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Monitoring System Certification <br />A Results of Testing/Servicing <br />Software Version Installed; <br />Complete the followine checklist: <br />It Yes <br />❑ NO <br />Is the audible alarm operational? <br />Yes <br />❑ No* <br />is the visual alarm operational? <br />Yes <br />❑ No* <br />Wereall sensors visual ins ected, functionally tested, and confirmed operational? <br />Yes <br />❑ NO <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br />not interfere with their proper operation? <br />❑ Y es <br />Ll NO <br />if alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) <br />N/A <br />operational? <br />Yes <br />❑ No' <br />For pressurized piping systems, does the turbine automatically shut down if the piping seconday containment <br />❑ N/A <br />monitoring system detects a leak, fails to operate, or is electrically disconnected? if yes: -which sensors initiate <br />positive shut -down? (Check all that apply) 0 Sump/Trench Sensors; P� Dispenser Containmc Sensors. <br />Did you confirm positive shut -down duo to leaks Ago, sensor failure/disconnection? A Yes; ❑ <br />❑ Yes <br />❑ No* <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device <br />(i.e., no <br />14 N/A <br />mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible <br />at the tank- <br />ankfill <br />fillpoint(s) and operating properly'? If so, at what percent of tank capacity does the alarm trigger, <br />9/0 <br />❑ Yes* <br />No <br />Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equi <br />went replaced <br />and list the manufacturer name and model for all replacement parts in Section E, below_ <br />Was liquid found inside any secondary contoimment systems designed as dry systems? (Check althat <br />❑ Yes* <br />No <br />apply) <br />❑ Product; ❑ Water. if yes, describe causes in Section E, below. <br />Yes <br />❑ No' <br />Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable <br />Yes <br />❑ No* <br />Is all monitoring equipment operational per manufacturer's specifications? <br />UN -036 - 3/6 <br />www.aaidpce.org <br />RM 01117108 <br />90/Ell 39rd GOOA SVO 3FJO `v' 9L9LICE860Z bZ:9T ZTO3/TE/ZT <br />