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Software Version Installed: �_. off <br />Comnlete the following checklist: <br />W,Ves <br />❑ No* <br />Is the audible alarm operational? <br />Yes <br />❑ No* <br />Is the visual alarm operational? <br />CI�Yes <br />❑ No* <br />Were all sensors visually inspected, functionally tested, and confirmed operational? <br />'Yes -- <br />- ❑--No-*` <br />-Gere all sensors installed at lowest point of secondary containment and positioned so that other egiiipmef f will <br />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 />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 initiate <br />positive shut -down? (Check all that apply)ump/Trench Sensors; ispenser Co ainment Sensors. <br />Did you confirm positive shut -down duet leaks and sensor failure/ 'sction? es; ❑ No. <br />Yes <br />❑ No* <br />For tank systems that utilize the monitoring system as the primary tank ovettill 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 />fiJl� b nt(s) and operating properly? If so, at what. percent of tank capacity does the alarm trigger? <br />'( <br />(� % <br />❑ Yes* <br />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 />Yes* <br />4 No <br />Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br />i <br />❑ Product; ❑ Water. If yes, describe causes in Section E, below. <br />es <br />❑ No* <br />Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable <br />Yes <br />❑ No* <br />Is all monitoring equipment oerational per manufacturer's specifications? <br />* In Section E below, describe how and when these deficiencies were or will be corrected. <br />E. Comments: <br />Page 2 of 3 03101 <br />