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JUL-01-2011 08:31 Service Station Systems 408 938 8888 P.04 <br /> Monitoring System Certification-Page 2 of 3 <br /> Site Address: 2448 W. Kettlernan Ln. Date of'festing/Servicing: 5/31/11 <br /> D. Results of Testing/Servicing <br /> Software Version Installed' 122.00 <br /> Com lete the followin-checklist., <br /> a Yes I ❑ No's is the audible alarm operational? <br /> 0 Yes ❑ No* Is the visual alarm Operational? <br /> a Yes ❑ No* Were all sensors visually inspected,functionally tested,and confimicd operational? <br /> 0 Yes 0 No* 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 /> ❑ Yes ❑ No's if alarms arc relayed Eo a remote monitoring station, is all communications equipment(e.g.modem) <br /> ® N/A operational'? <br /> 9 Yes ❑ No* For pressurized piping systems,docs the turbine automatically shut down if the piping,secondary containment <br /> ❑ N/A 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) 0 Sump/Trench Sensors; 0 Dispenser Containment Sensors_ <br /> Did XOLI confirm positivo shut-down due to leaks and sensor failure/disconnection? 3 Yes M No <br /> ❑ Yes ❑ Noy` 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 ovcrf111 warning alarm visible and audible at the tank <br /> fillpoint(s)and operating ro erl ? If so,at what percent of tank capacity docs the alarm trigger? 0 % <br /> ❑ Yes* 0 No Was any monitoring equipment replaced'?I f 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* 0 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 L,below. <br /> a Yes ❑ No* Was monitoring system set-up reviewed to ensure proper settings? (Attach set-u p re arts, il"applicable.2 <br /> ® Yes 0 No* Is all monitoring equipment operational per manufacturer's specifications'? <br /> In Section E below,descrihe how and when these deficiencies were or will be corrected. <br /> E. Comments: <br />