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• <br /> D. Results of Testing/Servicing • <br /> Software Version Installed: <br /> 329,00 <br /> Com tete the followin I checklist: <br /> ® Yes ❑ No- Is the audible alarm operational? <br /> ® Yes ❑ No' Is the visual alarm operational? <br /> ® Yes ❑ No' Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> ® Yes ❑ No- Were all sensors installed at lowest point of Secondary ry containment and positioned so that other equipment will not interfere with their proper <br /> ❑ Yes ❑ No- It alarms are relayed to a remote monitoring station,is all communications equipment <br /> ® N/A <br /> ❑ Yes ® No' (e.g,,modem)operational? <br /> For pressurized piping systems,does the turbine automatically shut down if the piping secunda <br /> ❑ N/A fails to operate, or n electrically disconnected? If yes: which sensors initiate ifhe positive shut-down? (Check al/that <br /> Sensors; p secondary containment monitoring system detects a leak, <br /> ❑Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? app/yl SUMP/Trench <br /> ❑ Yes ❑ No' For tank systems that utilize the monitoring system as the rima ❑Yes; ®No. <br /> ® N/A installed),is the overfill warning alarm visible and audible at the tank fill poll nt(s)and operating warning device ope no mechanical overfill prevention valve is <br /> does the alarm trigger? % P g properly? If so,at what percent of tank capacity <br /> ❑ Yes ® No Was any monitoring eceipment replaced? If yes,identify specific sensors,probes,or other equipment replaced and list the manufacturer name <br /> andModel oriel for all rec ace.ment parts in a If e,below. <br /> ❑Yes' 0 No Was .quid found insi.-e&,j secondary con:a:nment systems designed as dry systems? (Check alt that apply) <br /> = croduct; ❑Wa•ar I`res,describe ca;:ses in Section E,below. <br /> ® Yes as monitoring sys:e—Se!,;p reviewed o ensure proper settings?All ch set up reports,if applicable <br /> ❑ Yes ❑ w.' s a. monitoring equip-e,z operations' ­_ manufacturer's specifications? <br /> `In Section E besoiw,desc-roe how and when these deRclill were or will be corrected. <br /> E. comments: SITE DOES LINE TESTING IN LUE OF POSITIVE SHUTDOWN. <br /> 2/21/07 <br /> Page 2 of 4 <br /> Monitoring System Certification <br />