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JUL-02-2010 16:37 Seruice Station Systems 408 932 8888 P.OS <br />Monitoring System Certification - Pa, of 3 <br />Site Address: 1987 West 11Th. Street <br />D. Results of Testing / Servicing <br />Software Version Installed. 329.01 <br />Comnlete the followinn checklist: <br />Date of Testing/Servicing: 6/2/10 <br />12 Yes <br />0 No* <br />is the audible alarm operational? <br />Ix Yes <br />❑ No* <br />Is the visual alarm operational? <br />Ix Yes <br />❑ No* <br />Were all sensors visually inspected, functionally tested, and confirmed operational? <br />[x Yes <br />❑ No* <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 />0 Yes <br />0 No* <br />if alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br />13 N/A <br />operational? <br />C1 Yes <br />❑ No* <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />0 N/A <br />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) at Sump/Trench Sensors; [x Dispenser Containment Sensors. <br />Did you confirm positive shut -down due to leaks and sensor failure/disconnection? [K Yes ❑ No <br />11 Yes <br />❑ 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 />fillpoint(s) and operating properly? if so, at what percent of tank capacity does the alarm trigger? 90 % <br />0 Yes* <br />lB No <br />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 />0 Yes* <br />la No <br />Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br />0 Product; 0 Water. If yes, describe causes in Section E, below, <br />QE Yes <br />❑ No* <br />Was monitoring system set-up reviewed to ensure eroper settings? (Attach set -u. reports, if applicable) <br />IH Yes <br />0 No's <br />is all monitoring equipment operational per manufacturer's specifications? <br />" In Section <br />E below. describe how and when these deficiencies were or will be corrected. <br />E. Comments: Vent Sump Sensors - tested & passed. <br />All Sumps & UDC's are monitored by additional Brine Sensors. <br />91 & Diesel are split tanks and share Annular. <br />