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Monitoring System Certification <br /> A Results of Testing/Servicing <br /> Software Version Installed: 421.00 <br /> Complete the following checklist: <br /> El Yes ❑ No* Is the audible alarm operational? <br /> llti Yes ❑ No* Is the visual alarm operational? <br /> 21 Yes ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> ❑D 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 /> 21 Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br /> ❑ N/A operational? <br /> ❑ Yes ❑ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br /> O 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 ❑ 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 operating properly? If so,at what percent of tank capacity does the alarm trigger? 90 % <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 /> ❑O Yes ❑ No* Was monitoring system set-up reviewed to ensure ro er settings?Attach set up reports,if applicable <br /> O Yes ❑ No* Is all monitoring ui mentoperational per manufacturer's s ecifica[ions? <br /> *In Section E below,describe how and when these deficiencies were or will be corrected. <br /> E. Comments: <br /> Page 2 of 3 03/01 <br />