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FEB -04-2009 20:00 Service Station Systems 1'lomibring system t,erwicauon - raga , or a 408 938 8888 P.03 ,Site Address: Co - Date of Testing/Servicing, .j ` 2 a-Uoj T). . Results of T 60ng / Servicing Software Version Installed- _ Comblete the following checklist.- 13 hecklist: ❑ Yes . Cl No* Is. the audible alarm operational? ❑ Yes 0 No* Is the visual alarm operational? . ❑ Yes ❑ No* Were all sensors visually in cted, functionafly tested, and co armed operational? ❑ Yes ❑ No* Were all sensors installed at lowest point of secondary cont ' ent and positioned so that other equipment will not interfere with their proper operation? Q Yes. ❑ No* Nalarms are relayed to a remote monitoring station, ' all communications equipment (e.g. modem) p N/A o exational? 11 Yes ❑ No*.. For pressurized piping systems, does th/turbin utomatically shut down if the piping secondary containment a N/A monitoring system detects a leak, fails or is electrically disconnected? If yes: which sensors initiate .positive shut -down? (Check rzll that apmp/Trench Sensors; ❑ Dispenser Containment Sensors. Did ou confirm ositive shut -down dund sensor failure/disconnection? 0 Yes ❑ No ❑ Yes Q No* For tank systems that utilize the mo ' oring system as the primary tank overfill warning device (i.e. no 13 NIA mechanical overfill prevention val is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating roe ? If so at what percent of tank capacity does the alarm trigger? ❑ Yes* 0 No Was any monitoring equipme replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer na a and model for all replacement pws in Section E, below. ❑ Yes* 17 No Was liquid found inside aiX secondary containment systems designed as dry systems? (Check all that apply) 0 Product; 17 Water. If es describe causes in Section E, below. 13 Yes ❑ No*. Was monitoring systei)dset-up reviewed to ensure proper settin s7 Attach set-up reports, i alicable. ❑ Yes ❑ No* ' Is all monitoring eqVipment operational per manufacturer's specifications? xn Section E below, describe hour a d when these deficiencies were or will be corrected. E. Comments: