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A Res'uIts of Testing/Servicing t j <br /> Software Version Installed: <br /> Complete the followincy checklist: <br /> �d Yes ❑ No* Is the audible alarm operational? t, <br /> Yes l2 No* Is the visual alarm operational? <br /> pa Yes ❑ No* Were aII sensors visually inspected, functionally tested, and confirmed operational? F <br /> QYes ❑ 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? `r <br /> ❑ Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modern) <br /> ,l NIA operational? _ > <br /> ❑ Yes ❑ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br /> t3 NIA 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 confnm positive shut-down due to leaks and sensor failure/disconnection? ❑ Yes; ❑No. <br /> M Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br /> .NIA 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 ercent of tank capacity does the alarm trigger? % <br /> ❑ Yes* Gi 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 re lacement parts in Section E,below. <br /> ❑ Yes* 6 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 set up re orfs,if applicable <br /> JO 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 /> E. Comments: _ fy►ac �1 -tt- >t Cs-, 1A;��, <br /> Page 2 of 3 03101 <br />