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Monitoring System Certification Oc Site Address: . of"Testing/Servicing: D. Results of Testing/Servicing Software Version Installed: j-7- a Complete the following checklist: Yes ❑ No* is tlae audible alarm operational? J&Yes ❑ No* Is the visual alarm operational'? Yes ❑ No* Were all sensors visually inspected, functionally tested,and confirmed operational? Yes ❑ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? ❑ Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) 1A N/A operational? ❑ Yes ❑ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment ❑ N/A monitoring system detects a leak, Fails to operate, or is electrically disconnected'? If yes: -which sensors initiate positive slltlt-down? {(,heck it//that alrply) 9 Sump/'Trench Sensors; ❑ Dispenser Con tainmei4f-'§ensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? 0 Yes; ❑ No. ❑ Yes ❑ No* -T—or tank systems that utilize the monitoring system as (lie primary tank overfill warning device.{i.e. no /0'�N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at.ihe tank fill point(s)and operating properly? If so,at what percent of tank capacity does the alarm trigger? ` % ❑ Yes* )ff,No Was any monitoring equipment r€ laced? IF yes, identify specific sensors,probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E,below. ❑ Yes* No Was liquid found inside any secondary containment systems designed as dry systems? (Check all,that apply) ❑ Product; ❑ Water. If yes,describe causes in Section E,below. Yes ❑ No* Was monitoring system set-tip reviewed to ensure proper settings? Attach set up reports, if applicable Yes ❑ NO 'is all monitoring equipment operational per manufacturer's specifications? * In Section E below, describe how and when theca deficiencies were or will he corrected. F. Comments: