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• <br />1. Results of TestingrServiciM <br />Sokware Version Installed: <br />RECEIVED <br />MAY 2 1 2015 <br />('.pm am the Tollowr <br />X Yes 7 No' <br />9r .rH - <br />Is the audible 212M operational? <br />X Yes 7 Na- <br />Is the visual alarm operational? <br />! X Yes ] No' <br />Wem as sen m visually inspected, rurgbnally tested, and ooMimred operational? r r n oh T14C <br />I X Yes 7 No' <br />Were an sensors installed at lowest point at secondary contelnmerd ant positioned m that other equipment wlU not irts. rewlth Tar <br />n <br />r o ration? <br />if relayed to a remote monitoring station, a all cmnmuracatrons equipmem (e.g. modem) Operational? <br />_ Yes 7 No' <br />alarms am <br />X NA <br />X Yes 7 No' <br />For pressurized pipet, system% does the turbine autorlatica Shut doom if are piping secondary cordamarem monitoring system <br />7 NA <br />aeiegs a leak, fails to opetate, a is elecIricaly discannected? If yes: which sensers initiate positive shutdown? (Check afi that appM) <br />X Sumpffrendt Sensors; Dispenser Containrnem Sensors. DM you corrfmn positive shut -down due to leaks and sensor <br />'3 Yes 7 NO. <br />taiure/diacommdian? X Yee' o No. <br />For tank systems that utilize the moniforirg system es the primary tank owM warning devilaa (i.e. nc mechanical overfil prevention <br />` X NA <br />valve is unstated), is are overfill wamig alarm visible and audible at the tank til POWs) and operating PmPedfn if So, at what Percent <br />X Yes' No <br />of lank mpacity does the alartn trlgcmft % <br />Was any monricring equipment replaced? It yes. identify Specific sensarS, Probes, or other equipment replaced and list the <br />manufacturer name and model for all re cement parts In Section E, below. <br />1 7 Vee• X No <br />Was liquid found inside arty secondary containment systems designed as dry "ems? (Check W1 that apply) 0 Product 0 Water If <br />desarbe MUMS in Section E, below. <br />X es 7 No' <br />Was monitoring system set-up revlewed to ensure proper settings? Attach set up reports, 8 applicable <br />I X Yes 7 No' <br />Is all monkorug equ'4rnent operational per manwadWrels speOrAbcoe? <br />' Ir: section E tetow, aesenoe now anp when orese wvrc w nm w <br />E. Commends: THE VEEDER ROOT 208 SENSOR IN THE 87 STP SUMP DID NOT PASS. IT WAS REPLCED AND RETESTED AT <br />THE TIME OF THE TEST, <br />Monitoring System Cerep ticn Page 2 of 4 72(67 <br />2 <br />2121107 <br />AL <br />T <br />� d dU4 L096 6ZAetN <br />