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Monitoring System Certification-Page 2 of 3 <br /> Site Address: 2600 W. Lodi Date of Testing/Servicing: 6/21117 <br /> D. Results of Testing/Servicing <br /> Software Version Installed• 333.06 <br /> Complete the following checklist: <br /> 0 Yes 1 0 No* I Is the audible alarm operational? <br /> n Yes 0 No* Is the visual alarm o erational? <br /> ® Yes O No* Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> i® Yes 0 No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br /> not interfere with their pro er operation? <br /> ® Yes O No* If alarms aze relayed to a remote monitoring station,is all communications equipment(e.g.modem) <br /> 0 N/A operational? <br /> ® Yes O No* For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment <br /> 0 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? 0 Yes O No <br /> ® Yes 0 No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.no <br /> 0 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 properly? If so,at what percent of tank capacity does the alarm trigger? 90 <br /> o Yes* 0 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* 0 No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> 0 Product;® Water. If es, scribe causes in Section E,below. <br /> ® Yes 0 No* Was monitoring system set-udereviewed to ensure proper settings? Attach set-up reports, i a licable. <br /> ® Yes 0 No* I 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: Removed Small Amount of Liquid from 87 and 89 Fill Sumps. <br /> JUl 0 5 20i1 <br /> �. ., - �ALTH <br />