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Software Version Installed: <br /> U(� ` <br /> Complete the following checklist: ' <br /> Yes ❑ Nu* Is the audible alarm operational? <br /> 1'es ❑ No* is the visual alarm operational? <br /> Q :,'es ❑ No* Were all sensors Visually inspected,functionally tested,and confirmed operational? <br /> ❑ Yc's ❑ No* Were all sensors installed WO.Vest point of secondary containment and positioned so that other equipment will <br /> not interfere with their proper operation? <br /> ❑ Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br /> LXN/A operational? <br /> Yes ❑ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br /> ❑ N/A monitoring system detects a leak,fails to operate,or is electrically discon►ected? If yes: which sensors initiate <br /> positive shut-down? (Check all that apply) d$ump/Trench Sensors; ;}Dispenser Cho tainment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? H Yes; ❑No. <br /> ❑ ' s ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br /> N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br /> L1 <br /> G fill point() and operating properly? if so, at what,percent of tank capacity does the alarm trigger? <br /> 0 <br /> :7 `•`es* No 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 /> J 'i es* No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> ❑Product; ❑ Water. If yes,describe causes in Section E, below. <br /> ,i es ❑ No* Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports,if applicable <br /> Ll .::s No* 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: , - � _';. I �V�� O��C^fl SeIV� � S <br /> -byVIrt-� wt re p' X.. <br /> t > - a CL � ; re , vUJ � I �e�r <br /> Page 2 of 3 03101 ... <br />