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Monitoring System Certification <br />I�ECEIVEG <br />D. Results of Testing/Servicing <br />MAY 2 7 2014 <br />Software version Installed: <br />Complete the folly <br />Yes <br />❑ No* <br />Yes. <br />❑ No* <br />Yes <br />0 No* <br />Yes <br />❑ Nod' <br />❑ YesQ, <br />No's <br />I,r�;( N/A <br />Yes <br />❑ No* <br />Q N/A <br />❑ Ycs <br />❑ Yes* <br />El Yes* <br />Yos <br />Yes <br />ENVIRONMENTAL <br />Is the audible alarm operational7 <br />Is the visual alarm operational? <br />Wcrc all sensors visually inspected, functionally tested, mid confirmed operational? <br />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 />If alarms are relayed to a rcmote monitoring station, is all communications equipment (e.g., modem) <br />operational? <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />monitoring system detects a leak, fails to operate, or is electrically disconnected? Ifycs: -which scissors initiate <br />positive shut -down? (Check all that apply) 0 Sump/'l rench Sensors; 0 Dispenser Containment Sensors. <br />Did you confirm positive shutdown due to leaks qnd scissor failurc/disconnectlon? a Yes; [] No. <br />❑ No* I For funk systems that utilize the monitoring system as the primary tank overfill warning device (i.e., no <br />kj N/A mechanical overfill prevention valve is installed), is the overfill warning alma visible and audible at the tank <br />-fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm triger7 % <br />No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other cquipmont replaced <br />and list the manufacturer name and model for all replacement parts in Section E, below. <br />No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br />d Product; ❑ Water. If yes, dcscribe causes in Section E, below. <br />Cis NO* Was monitoring systom set-up reviewed to ensure proper settings? Attach set up reports, if applicable <br />❑ No* Is all monitorine eordnme„t <br />* In Section E below, describe how and when these deficiencies were or will be corrected. <br />E. Comments: <br />❑N-036 - 3/6 <br />ft <br />www.uuidomom <br />Itcv. 0 1/17/08 <br />S:d'd 22t7289t':01 96ztitiZS602 89NdI_1dW03 1SCOWOHd 9S:,LO t7I©2-b2-AHW <br />