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D. Results of Testing/Servicing <br /> Software Version Installed: <br /> Complete the following checklist: <br /> es ❑ No* Is the audFan operational? <br /> Xes ❑ No* Is the visperational? <br /> U s ❑ No* Were all ually inspected, functionally tested, and confirmed operational? <br /> Yes ❑ No* Were all talled at lowest point of secondary containment and positioned so that other equipment will <br /> not interfeir proper operation? <br /> ❑ Yes ❑ Nom* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br /> C3 N/A operational? <br /> L! 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 O <br /> 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? El Yes;_❑ No. <br /> ❑ Yes No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br /> C3NIA mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br /> fill point(s)and operating properly? If so,at what percent of tank capacity does the alarm trigger? % <br /> ❑ Yes* 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 proper settings?Attach setup reports,if applicable <br /> Yes ❑ No* Is all monitoring equipment operational per manufacturer's specifications? <br /> *In Section E below, describe how and when these deficiencies were or will be corrected. <br /> V' Comments: <br /> Page 2 of 3 03/01 <br />