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,'oionitoriba Svstem Certification <br /> Site Address: _ Date of Tc=R/Servicins: <br /> D. Results of Testing/Servicing <br /> Software Version Installed: <br /> Complete the following checklist: <br /> r Q,"�ps ❑ No* I Is the audible alarm operationaI9 <br /> ❑ No* Is the visual alarm operational? <br /> Y I ❑ No* Were all sensors visually inspected.functionally tested and confirmed operational'! <br /> es ❑ No* Were all sensors installed at lowest point of secondan, containment and positioned so that other equipment <br /> will not interfere with their proper ope=on? <br /> ❑ Yes ❑ No* If alarms are relaved to a remote monitoring station. is all communications equipment (e.g. modem) <br /> p�N/A operational? <br /> ts ❑ No* For pressurized piping systems. does the turbine automaticallv shut down if the piping secondary containment <br /> ❑ N/A monitoring system detects a leak, fails to operate, or isf ectrically disconnected? yes: which sensors <br /> initiate positive shut-down? (Check all that apply) 4ZSump/Trench Sensors, 0Dispenser Containment <br /> Sensors. <br /> Did You confirm positive shirt-down due to leaks and sensor failure/disconnection? ❑ No. <br /> Yes j ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br /> 1 ❑ N/A + mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br /> fill int(s)and operating property? If so, at what percent of tater capacity does the alarm trigger? ????%o �S <br /> ❑ Yes* No Was any monitoring equipment replaced? If ves. identify specific sensors, probes. or other equipment <br /> replaced and list the manufacturer name and model for all replacement parts in Section E, below. <br /> ❑'Yes* ❑ No Was liquid found inside any secondan- containment systems designed as dry systems? !Check all that apply) <br /> ❑ Product_' ❑ Water. If ves_describe causes in Section E. below. <br /> es X ❑ No* Was monitoring system set-rip reviewed to ensure proper Settings7 <br /> Yes i ❑ No* Is all monitoring equipment operational per manufacturer's cations? <br /> * In Section E below,describe how and when these deficiencies were or wit) be corrected. <br /> SCC <br /> E. Comments: LAI <br />