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• • HECEiVE® <br /> D. Rel ults of Testing/Servicing <br /> Software ersMAY272015ion Installed: 8.04 (� <br /> Complete he folwin checklist: EIVVj AL <br /> 0 Yes ❑ No' I Is the audible alarm operational? U nCD8OT4sC IT <br /> 0 Yes ❑ No' Is the visual alar operational? <br /> 0 Yes ❑ o' Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> 0 Yes Elo' 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 /> 0 N/A <br /> ® Yes ❑ No' For pressurized piping systems,does the turbine automatically shut down rf 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) 0 Sumpfrrench <br /> Sensors; O Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? 0 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 /> 0 N/A installed),is the overfill warning alarm visible and audible at the tank fill point(s)and operating properly? If so,at what percent of tank capacity <br /> does the alar tdgger7 % <br /> ❑ Yes 0 No Was any monitoring equipment replaced? If yes,identify specific sensors,probes,or other equipment replaced and list the manufacturer name <br /> 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 /> ❑Product; ❑Water. If yes,describe causes in Section E,below. <br /> 0 Yes ❑ No' Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports,0 applicable <br /> 0 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 Sy tem Certification Page 2 of 2/21/07 <br />