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0itoring System Certification • <br /> Site Address 2725 COUNTRY CLUB BLVD Date of Testing/Service: 03/24/2010 <br /> D. Results of Testing/Servicing <br /> Software Version installed: 327.04 <br /> Complete the following checklist: <br /> Yes No' Is the audible alarm operational? <br /> QX Yes ❑No. Is the visual alarm operational? <br /> ❑X Yes 0No" Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> ❑X Yes ❑No` <br /> Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not <br /> interfere with their proper operation? <br /> X Yes No N/A If alarms are relayed to a remote monitoring station,is all communications equipment(e.g. modem)operational? <br /> For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment <br /> ❑X Yes ❑No ❑NIA monitoring system detects a leak,fails to operate,or is electrically disconnected? If yes:which sensors initiate positive <br /> shut-down?(check all that apply) ij Sump/Trench sensors: ❑X Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ❑X Yes ❑No <br /> ❑ <br /> X Yes No N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.:no mechanical <br /> ❑ ❑ overfill prevention valve is installed),is the overfill warning alarm visible and audible at the tank fill points(s)and operating <br /> 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 and list the <br /> manufacturer name and model for all replacement parts in Section E,below. <br /> Yes' 0 No Was liquid found inside any secondary containment systems designed as dry systems?(check all that apply) ❑Product; <br /> ❑ Water. if yes,describe causes in Section E,below. <br /> ❑ Yes ❑No' Was monitoring system set-up reviewed to ensure proper settings?Attach set-up reports,if applicable. <br /> F-11 Yes ❑No" Is all monitoring equipment operational per manufacturers'specifications? <br /> *In Section E below,describe how and when these deficiences were or will be corrected. <br /> E. Comments: <br /> Page 2 of 3 Based on CA form dated 03108 <br />