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Monitoring System Certification Site Address: Date of Testing/Servicing. D. Results of Testing/Servicing Software Version Installed: Cooviete the foll! 'ng checklist: 122 .Yes ❑ No* Is the audible alarm operational? Yes O No* Is the visual alarmoperational? Yes ❑ No* 1 Were all sensors visually ected, bnctio lally tested, and confirmed rational? p Yes Q No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their Pro= omration? ❑ Yes ❑ o* N/A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) C operational? Yes ❑ No* ❑ N/A For pre urized piping kms, does the turbine automatically shut down if the m secon (rip g containment monitoring system detects a leak, fails to some s operate, or is electrically disconnected? [f yes: which sensors initiate shut positive -down? (Check all that apply) ❑ Sump/Trench Sensors; ❑ Dispenser Containment Sensors. Did you confirm positive shut -down due to leaks and sensor fail ure/disconnection. � O Yes; ❑ No. ❑ Yes ❑ No* Q N/A For tank systems that utilize the monitoring system as the primary device mechanical overfill prevention valve is installed), karmv�le and is the overfiwarning a� the tank fill point(s2 and o ratin 1 ? If so, at ❑ Yes* p No what percent of tank capacity does the alarm tri er? ????"/o Was any monitoring equipment replaced? If yes, identify specific sensors, r or laced and List the manufacturer name and for 0 Yes* 01�0 lower equipment model all replacement in Section Was liquid found inside any secondary containment systems designed as ❑ Product' ❑ Water. If es describe causes in Section E, below dry systems? (Check all that apply) ❑'Yes 0 No* Was monitoring stem set-up reviewed to ensure se= s? OJYes O No* Is all monitorin& Equipmento rational per manufacturers cations? * In Section E below, describe how and when these deficiencies were or will be corrected, E. Comments: