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Monitoring System Certification-Page 2 of 3 <br /> Site Address: 610 S.Cherokee Ln. Date of Testing/Servicing: 10/25/16 <br /> D. Results of Testing/Servicing <br /> Software Version installed, 333.04 <br /> Com Mete the fullowin checklist: <br /> Ed Yes ❑ No* I Isthe 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 containment and positioned so that other equipment will <br /> not interfere with their proper operation? <br /> p Yes ❑ No* If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem) <br /> is 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 strive shut-down due to leaks and sensor failure/discomteclion? 0 Yes O No <br /> k(3Yccs* <br /> Yes ❑ 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 /> fill point(s)and operatin property? If so,at what ercent of tank capacity does the sterni trigger? 0 ^/„ <br /> ® 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 arts in Section E,below. <br /> s* ® No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> ❑ Product;13 Water. If es,describe causes in Section E,below. <br /> ® Yea ❑ No* Was monitoring system set-up reviewed to ensure proper settings? Attach gel-lip re ores, i a licahle. <br /> ® Yes ❑ No* Is all monitoring equipment operational per manufacturers specifications? <br /> •In Section E below,describe haw 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 />