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Mr -�toring System Certification ./ <br /> Site Address 16470 CAMBRIDGE Date of Testing/Service: 1 et/2008 <br /> D. Results of Testing/Servicing <br /> Software Version Installed: 14.04 <br /> Complete the following checklist: <br /> X Yes No• Is the audible alarm operational? <br /> ❑X Yes ON.-I Is the visual alar operational? <br /> ❑X YesNo' Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> Q Yes ❑No• Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not <br /> interfere with their proper operation? <br /> Yes No' FX- NIA If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem)operational? <br /> For pressurized piping systems,does the turbine automatically shut down If the piping secondary containment <br /> 0 Yes ❑No' ❑NIA monitoring system detects a leak,fails to operate,or is electrically disconnected?If yes:which sensors initiate positive <br /> shut-down?(check all that apply) ❑X Sump(rrench Sensors; ❑ Dispenser Containment Sensors. <br /> Did you oonfir positive shut-down due to leaks and sensor failureldisconneclion? ❑x Yes No <br /> F-1 Yes ❑No• ❑X NIA For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.:no mechanical <br /> overfill prevention valve is installed),is the overfill warning alar visible and audible at the tank fill points(s)and operating <br /> properly? If so,at what percent of tank capacity does the alarm trigger? % <br /> ❑ Yes' ❑X No Was any monitoring equipment replaced?If yes,identify specific sensors,probes,or other equipment replaced and list the <br /> manufacturer name and model for all replacement parts in Section E,below. <br /> ❑ Yes* ❑x No Was liquid found inside any secondary containment systems designed as dry systems?(check all that apply) ❑Product; <br /> ❑ Water. If yes,describe causes in Section E,below. <br /> ❑X Yes ❑No' Was monitoring system set-up reviewed to ensure proper settings?Attach set-up reports,if applicable. <br /> ❑X Yes ❑NoIs all monitoring equipment operational per manufacturers'specifications? <br /> In Section E below,describe how and when these deficiences were or will be connected. <br /> E. Comments: <br /> Page 2 of 3 Based on CA form dated 03/01 <br />