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09/22/2001 09:29 6347 SHELY PAGE 01 <br /> t Monitor Certification Inspection <br /> • ARCO Products Company <br /> This certifies that the tnonitor(s) is/are in place, the probes are in correct position and the system <br /> is op g properl . <br /> Stati / Date 20 <br /> Ad / 14110A SOL" Type Inspection: <br /> I /X PI o p _ Annual Permit <br /> Recheck Leak <br /> r <br /> Type odel of Monitor ►' �� 7-X 2 - ' CC) <br /> Syst nction <br /> Tan Annular Space In Tank <br /> Pass Fail N/A Pass Fail N/A <br /> Regu - _ <br /> Mid <br /> Su <br /> pr <br /> ws <br /> Othe <br /> Pr Ines Turbine Sump In-Line Fill Sump <br /> Paas Fail N/A Pass Fail ! Pass Fail N <br /> Re X_ <br /> Mid <br /> Was — <br /> Was <br /> Sup <br /> Othe — <br /> Whe nitor is turned off or in alarm, is there positive shutdown of turbines? Yes No <br /> If N re precision product line tests performed? Yes No <br /> Mon anel <br /> Is th itor panel mounted and labeled correctly? i <br /> Doe itor alarm horn function properly? Ve <br /> Is p cessible and visible to station personnel? f <br /> Rep) all failed probes? Yes -- No N/A - <br /> If N obes to be replaced/repaired by (Date) — <br /> Insp By: Contractor. <br /> Technician <br /> Signature <br /> APC-3 ( ) <br />