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....,wwuug�yalelll l.CrlllleIllall <br /> r. Facility Name: Bob Cat9entral •Date at iestmgiServicmg:j /9 /01 <br /> D. Results of Testing/Servicing <br /> Complete the following checklist: <br /> W Yes ❑ No* is the monitoring system operational per manufacturer's specifications? <br /> ® Yes ❑ No* Is the audible alarm operational? <br /> ® Yes LINo" Is the visual alarm operational? <br /> ® Yes ❑ No" I Were all sensors visually inspected, tested,and confirmed operational? <br /> ® Yes ❑ No* Were all sensors and probes reinstalled properly? <br /> ❑ Yes XI No* Is all monitoring equipment secured from unauthorized tampering? <br /> ❑ Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br /> lip N/A operational? <br /> * Yes ❑ No* If needed by any monitoring equipment,are replacement fuses and/or batteries available? <br /> ❑ N/A <br /> ❑ Yes %I 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 sensors initiate <br /> positive shut-down? (Check all that apply) ❑ Sump/Trench Sensors; ❑Dispenser Containtric nt Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ❑ Yes; ❑No. <br /> ❑ Yes ❑ No* For monitoring systems that also serve as tank overfill warning devices, is the overfill wam g alarm visible <br /> XI N/A and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capacity does the <br /> alarm trigger? % <br /> ❑ Yes* X] 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 FI No Was any system software upgraded? If yes,identify the new version number in Section E,bel <br /> ❑ Yes* X] No Was liquid found inside any secondary containment systems? (Check all that apply) ❑ Produ t; ❑ Water. If - <br /> es,describe causes in Section E.below. <br /> * In Section E below,describe how and when these deficiencies were or will be corrected. <br /> E. Comments: Small amount of water in diesel pipe sump. <br /> Impact Valves tested. <br /> Page 3 of this Certification must be completed and attached only if one or more of the following conditions re met: l.) In- <br /> tank gauging equipment is used to perform leak detection monitoring; Z.) Line leak detectors are installed on piping s'stenis: <br /> 3.) Completion is required by your local agency that regulates UST systems. <br /> CALM-o, Page 2 06!23;99 <br />