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Monitoring System Certification <br />Site Address: <br />D. Results of Testing/Servicing <br />Software Version Installed: <br />Complete the following checklist: <br />Date of Testing/Servicing: <br />f -Yes <br />❑ No* <br />Is the audible alarm operational? <br />Yes <br />❑ No* <br />Is the visual alarm operational? <br />2r -Yes <br />❑ No* <br />Were all sensors visually inspected, functionally tested, and confirmedoperational? <br />9 -Yes <br />❑ No* <br />Were i l sensors installed at lowest point of secondary containment and positioned so that other equipment <br />will not interfere with their proper operation? <br />❑ Yes <br />❑ No* <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br />gq-N/A <br />operational? <br />Yes <br />❑ No* <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />❑ N/A <br />monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors <br />initiate positive shut -down? (Check all that apply) [�Sump/Trench Sensors; R'Dispenser Containment <br />Sensors. 1 <br />Did von confirm positive shut -down due to leaks and sensor failure -/disconnection? P -Yes, ❑ No. <br />❑ Yes <br />e -No* <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br />❑ N/A <br />mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br />fill point(s) and operating ro rf ? If so, at what percent of tank capacity does the alarm tri gerl ''"'";'n <br />❑ Yes* <br />5a'No <br />Was arr monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment <br />I <br />re laced and list the manufacturer name and model for all replacement parts in Section E, below. <br />❑ Yes* <br />2 -No <br />Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) j <br />❑ Product: ❑ Water. If ves, describe causes in Section E. below. <br />(-Yes <br />❑ No* <br />Was monitoring system set-areviewed to ensure proper settings? <br />19'Yes❑ <br />No* <br />Is all monitoring ment operational per manufacturer's cations'? I <br />* In Section E below, describe how and when these deficiencies were or will be corrected. <br />E. Comments: <br />