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C. rtificstion . I eerdr r <br /> uuau6cion Issc correct <br /> c a A ed to th$Certma�iun}Is informaoj In h�nis doeume�.� "I"'cted/serviced la accordance wit <br /> reports,jab wroett and a Ply len showing the uyoul of monitorin <br /> reports,l have also attached (gul manufacturers'any checklists)necessa <br /> TechoI a copy otthe re orf Y C9nlpmeni For an rY to verify the <br /> t Name(print): J� +a h,r 1 P' v Lchecr eTUratapplYlt S Ate Y P u1PIDeA Capable of generating <br /> Si nt so-up larm tory P <br /> CCrtrficadoa No Da to —p s_( � S f Signature.- r report <br /> Testing Company Name: (� ' ; c e Y c License.No.. <br /> Site Address, t}$o o= r��✓, STv�c t Phone No.: 7 D Z ,Z 1� -7 2' <br /> Date of T <br /> estingJSeryicing: <br /> 1Honitoring System Certification <br /> D. Results of Testing/Serv,cing <br /> S011wart Vcm!On Installed: I-1 , 0 -2— <br /> Cow <br /> Com letethefollowin checldLst: <br /> es No' Is the audible alarm o ona11 <br /> ye es O NO Is th visual alarm orad? <br /> No Wero all sensors visual) <br /> Yes 01 No Were all seta fumcdonal <br /> ors installed at lowest point of festtd and confumed° ionalp <br /> will not interfero with their o don? co 1:1 <br /> O Yes O No' If alarms am relays t4 a and Iwsitioned so that other equipn3en <br /> WA opczetional? senroe monitoring station, is all co <br /> Ya 0 NO* Forpressurized r does the mmuntcaLons egttipmeut <br /> 0 VA monitorin P ping systems turbine (e.g. mO�• <br /> positive Shutt--dowwnt?detected fidjs 1O oPCI or is Ia�tn'�y t dd cc <br /> d'C PIT g secwttJary conte <br /> Did' on conium apply) sum ted? Ifycs; w � <br /> ❑ Ya O No• For tank sitive Abut-down due to Jeal s I��� Sensors: t]b Which se <br /> fuors initiate <br /> systems that utilize lid sensor failurt/discontt PenseT Containment Sensors. <br /> �wA MCchanical overfill prevention Valu Is nurstall� system as the Ptitnary tank ove? �' ❑No. <br /> 0 Yes. fill int s and o ratan Cha, Ls the overfill <br /> No Was any all 1 If at what warmrm8 alarm vis e m�8 device (i.e. no <br /> and list the erg equipment r aced? If t of tank ca an at the tank <br /> 4 Yes' manufacturer Yts idt 1 dots the a! <br /> No O Prliquid found inside army name <br /> wn a �sPmifie s�Section E w C P ent replaced <br /> all lacernent mom'Probes, to other w <br /> Yes. ❑ No• 0 Water If es describe s Mems des' below. <br /> Was monito ' ' causes m Sextloa geed drY systems? <br /> Yes ❑ N's s stem set-u reviewed toe below. (C all tfrot opp[y) <br /> Is all monitotin u' ell rational <br /> In <br /> Sectio'E, rutut ro r settin s?Attach set u re lts <br /> below,describe how and when thesermanufacturer's s ifications? !fa liable <br /> deficiencies were or will be <br /> E Comments: �cc� (L'4� 5�-n < corrected, <br /> 14 Li t ✓Lc wt <br /> a. L_.e,xe � 'CR. .'[ .�UY <br /> ra.' luhS . <br /> � <br /> "Y1 2 <br /> �O`te3C� (3p ce Q� �czytlGS <br />