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4 <br /> A Results of Testing/Servicing <br /> Software Version Installed: 421.00 <br /> Com tete the folle ng checklist: <br /> ❑x Yes ❑ No* Is the audible alarmoperational? <br /> ® Yes ❑ No* Is the visual alarm operational? <br /> D Yes ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> Hl Yes ❑ No's Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br /> not interfere with their pwper operation? <br /> ® Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br /> 0 NIA operational? <br /> ❑ Yes U No* For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment <br /> ® NIA 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' l3 No. <br /> ❑ Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br /> ® NIA mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br /> fill pointW and operating properly? If so,at whatpercent of tank capacity does the alarm trigger? J90 % <br /> ❑ Yes* []No Was any monitoring equipment replaced? If yes,identify specific sensors,probes,or other equipment replaced <br /> and list the maunilicturer name and model for all replacement parts in Section E,below. <br /> ❑ Yes* M 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 /> Q Yes 0 No* Was monitoring system set-up reviewed to ensure proper settings?Attach set up re orfs,if a licable <br /> ©Yes ❑ No* Is all moniforinS equipment operational per manufacturer's specifications? <br /> *In Section E below,describe how and when these deficiencies were or will Im corrected.. <br /> E. Comments: <br /> Page 2 of 3 03/41 <br /> I <br /> AA <br /> II <br />