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Monitoring System Certification-Page 2 of 3 RECEIVED <br /> Site Address: 610 S.Cherokee Ln. Da��f Teati�a'bervieing: 10/25/16 <br /> D. Results of Testing/Servicing N G G U <br /> Software Version Installed. 333.04 ENVIRONMENTAL HEALTH <br /> DEPARTMENT <br /> Complete the following checklist: <br /> ® Yes ❑ No* I Is the audible alarm operational? <br /> ® Yes l7 No* Is the visual alarm operational? <br /> ® Yes ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> ® Yes t7 No* 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 /> ❑ Yes ❑ No* If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem) <br /> 11 N/A operational? <br /> ® Yes ❑ No* For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment <br /> ❑ N/A 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) ® Sump/Trench Sensors; ® Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ® Yes ❑ No <br /> ❑ Yes 11 No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.no <br /> ® N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br /> fillpoint(s)and operating properly? If so,at what percent of tank capacity does the alarm trigger? 0 0/01 <br /> ❑ Yes* ® No Was any monitoring equipment replaced?If yes,identify specific sensors,probes,or other equipment replaced <br /> and list the manufacturer name and model for all replacement parts in Section E,below. <br /> ❑ Yes* ® No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> ❑ Product;❑ Water. If yes,describe causes in Section E,below. <br /> ® Yes 0 No* Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports i a licable. <br /> ® Yes ❑ No* I Ts all monitoring equipment operational per manufacturer's specifications? <br /> *In Section E below,describe how and when these deficiencies were or will be corrected. <br /> E. Comments: Replaced TLS Battery for PM purposes. <br /> 87& 91 are split tanks and share Annular. <br />