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esuks of Testkng/Servicing <br /> Soft'svare Version Installed: <br /> Complete the following checklist: <br /> 0 Yes C] No* Is the audible alarm operational? _ <br /> lb Yes --❑ No* Is the visual alarm operational? <br /> 0 Yes ❑ No* Were all sensors visually inspected, functional] 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 /> ❑ Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br /> 13 N/A operational? <br /> W 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) ETSump/Trench Sensors; OP Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? IR Yes; ❑No. <br /> D 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 /> P j 3RAfillpoint(s)and o erating properly? If so,at what percent of tank capacity does the alarm trigger? % <br /> CI Yes* 0 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 ❑ No* Was monitoring system set-up reviewed to ensure Eroper settings?Attach set up reports, if applicable <br /> ® Yes C] No* I Is all monitoring equipment oerational per manufacturer's specifications? <br /> * In Section E below,describe how and when these deficiencies were or will be corrected. <br /> E. Comments: <br /> Ps-e 2 of 3 <br /> 03101 <br />