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• WCENED <br /> D. Results of Testing/Servicing SEP 2 8 2016 <br /> Software Version Installed: 329.01 <br /> Complete the followinchecklist: U1111RONMENTAL HEALTH <br /> ® Yes ❑ No` Is the audible alarm operational? DERARTMPKIT <br /> ® Yes El No* Is the visual alar operational? <br /> ® Yes ❑ No' Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> ® Yes ❑ No' Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper <br /> operation? <br /> ❑ Yes ❑ No' If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.,modem)operational? <br /> ® N/A <br /> ® Yes ❑ No' For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak, <br /> ❑ N/A fails to operate, or is electrically disconnected? If yes:which sensors initiate positive shut-down? (Check all that apply) ® Sumpfrmnch <br /> Sensors; ®Dispenser Containment Sensors. <br /> Did you confirm positive shutdown due to leaks and sensor failure/disconnection? ®Yes; ❑No. <br /> ❑ Yes ❑ No' For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.,no mechanical overfill prevention valve is <br /> ® N/A installed),is the overfill warning alarm visible and audible at the tank fill polm(s)and operating property? If so,at what percent of tank capacity <br /> does the alar trigger? % <br /> ❑ Yes ® No Was any monitoring equipment replaced? If yes,identify specs is sensors,probes,or other equipment replaced and list the manufacturer name <br /> 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 set up reports,ff applicable <br /> ® Yes ❑ No' Is all monitoring equipment operational per manufacturers specifications? <br /> 'In Section E below,describe how and when these deficiencies were or will be corrected. <br /> E. Comments: <br /> Monitoring System Certification Page 2 of 4 2/21/07 <br />