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Site Address: SS#6335,4855 ST HWY99,STOCKTON Date of Testing/Servicing: / �—Lt{ a` <br /> D. Results of Testing/Servicing U <br /> Software Version Installed: `/q. O 1 <br /> Complete the follow ng checklist: <br /> Yes ❑ No* Is the audible alarm operational? <br /> 14 Yes ❑ No* Is the visual alarm operational? <br /> lia Yes ❑ No* Were all sensors visually inspected, functionally tested,and confirmed operational? <br /> la 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 /> ® 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) [�}Sump/Trench Sensors; [Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? 1l Yes; ❑No. <br /> ❑ Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br /> B N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br /> fill point(s)and operating ro erl ? If so,at what percent of tank capacity does the alarm trigger? ????% <br /> 1sl 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* V 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? <br /> p Yes 1 ❑ No* Is all monitoring equipment oerational per manufacturer's s ecifications? <br /> * In Section E below,describe how and when these deficiencies were or will be corrected. <br /> E. Comments: /10 i-5gcm I cl. ( AX 4L VApjL .(7 T-t;h-Zef) <br /> Ke-pinwO ate 1-h�-e- aw+�w� Sw.sw.s a�.�citer a,k. �gu;4o-K <br /> Page 2 of 3 03/01 <br />