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Monitoring System Certification-Page 2 of 3 Site Address: Date of Testing/Servicing: D. Results of Testing/Servicing Software Version Installed• Com Tete the follo ine checklist: ❑Yes - 13 No* Is the audible alarm operational? 13Yes ❑No* Is the visual alarm operational? ❑Yes 17 No* Were all sensors visually inspected,functionally tested,and co ed operational? ❑Yes ❑ No* Were all sensors installed at lowest point of secondary cont�#ient and positioned so that other equipment will not interfere with their proper operation? ❑Yes ❑ No* If alarms are relayed to a remote monitoring station,is communications equipment(e.g.modem) ❑N/A operational? ❑Yes ❑ No* For pressurized piping systems,does the turbine au matically shut down if the piping secondary containment ❑ N/A monitoring system detects a leak,fails to operatee6r is electrically disconnected? If yes:which sensors initiate positive shutdown?(Check all that apply) 'VSumpf nch Sensors; ❑Dispenser Containment Sensors. Did you confirm positive shut-down due to Jebks and sensor failure/disconnection? ❑Yes E3No ❑Yes ❑ No* For tank systems that utilize the monito ' system as the primary tank overfill warning device(i.e.no ❑ NIA mechanical overfill prevention valve is' talled),is the overfill warning alarm visible and audible at the tank fill Wings)and operating propefly? so,at what percent of tank capacity does the alarmtrigger? ❑Yes* ❑No Was any monitoring equipment repl ed?If yes,identify specific sensors,probes,or other equipment replaced and list the manufacturer name anmodel for all replacement parts in Section E,below. ❑Yes* ❑ No Was liquid found inside any secg6dary containment systems designed as dry systems? (Check all that apply) ❑Product; ❑ Water. If es be causes in Section E,below. ❑Yes ❑ No* Was monitoring stem set- reviewed to ensure ro setti ? Attach set-u re orts, 1 a licable. ❑Yes ❑ No* Is all monitorin ' me rational per manufacturer's iltcations? *In Section E below,describe bow and wh these deficiencies were or will be corrected. E. Comments: