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Monitoring System Certification <br /> �. Site Address: <br /> Date ofTesting/Servicing: <br /> A Results of Testing/Servicing <br /> Software Version Installed: –'./�'� <br /> Complete the following checklist: <br /> Yes ❑ No* Is the audible alarm operational? <br /> Yes ❑ No' I Is the visual alarm operational? <br /> E4, Yes ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> (7 Yes ❑ NO* Were all sensors installed at lowest point of secondary containment and positioned so that other ec*�i?meot will <br /> not interfere with their proper operation? <br /> ❑ Yes ❑ No' I£ alarms are relayed to a remote monitoring station, is all communications equipment (e.., modem) <br /> N/A operational? <br /> Yes CI 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 senors initiate <br /> positive shutdown? (Check all that apply) `®�Sump/£rench Sensors; ❑ Dispenser Containment S cr ors. <br /> Did you confirm positive shutdown due to l aks and sensor failure/disconnection? ECJ Yes; QNC. <br /> ❑ Yes ❑ No' For tank systems that utilize the monitoring system as the primary tank ove 11 warning de—e (i.e, no <br /> A N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audio:.- at the tank <br /> fill point(s)and operating properly? If so,at what percent of tank capacity does the alarm trigger? % <br /> ❑ Yes' No' Was any monitoring equipment replaced? If yes,identify specific sensors,probes,or other equip-.-at replaced <br /> and list the manufacturer name and model for all replacement parts in Section E,below. <br /> ❑ Yes• -No Was liquid In inside any secondary containment systems designed as dry systems? (Check a.. :hat apply) <br /> ❑Product; ❑Water. If yes,describe causes in Section E,below. <br /> h Yes ❑ No` Was monitoring system set-up reviewed to ensure proper settings? j <br /> 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: <br />