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Monitoring System Certification <br /> Site Address: Date of Testing/Servicing: <br /> D. Results of Testing/Servicing <br /> Software Version Installed: <br /> Complete the following checklist: <br /> Yes ❑ No* Is the audible alarm operational? <br /> Yes ❑ No* Is the visual alarm operational? I <br /> Yes ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> Yes ❑ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br /> not interfere with their proper operation? <br /> ❑ Yes ❑ No* If alarms are relayed to a remote monitoring station,-is all communications equipment (e.g. modem) <br /> NIA operational? <br /> AYes ❑ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br /> ❑ Nr/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)ACfSump/Trench Sensors; ❑ Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? Yes; ❑No. <br /> ❑ Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br /> )jb N/A mechanicai 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? % <br /> Rf yam* 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* 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 /> RI <br /> s ❑ No* Was monitoring system set-up reviewed to ensure proper settings? <br /> s ❑ 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: <br /> 97 Z . Pb �, _ erg -.1"A 6 2 00Z1;11 <br /> #d/ d , y Z <br />