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Matiitoriag System Certification <br /> RECEIVED <br /> D, Results of Testing/Servicing MAR2 4 2014 <br /> � <br /> Software Version installed: ENVIRONMENTAL HEALTHDEPARTMENT <br /> Com tete the folio "R checklist: <br /> rqm <br /> ffin Yes C) No* Is the audible alarm operational? <br /> Yes ❑ No* Is the visual alarm operational? <br /> Yes ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> Yes d No"' Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br /> not interfere with their roper operation? <br /> 1� Yes Cl No* If alarms are relayed to a remote monitoring station, is all communications aquipment (e.g., modem) <br /> te N/A operational? <br /> JiFYes ❑ 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) X Sump/Trench Sensors; I1 1)ispenscr Containment Sensors. <br /> Did you confirm positive shut-duwn due to leaksnA sensor failure/disconnection? ;I"Yos; ❑No. , <br /> Yes ❑ 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 /> fill point(s)and operating properly? If so,at what percent of tank capacity does the alarm trigger?R U <br /> ❑ Yes* �J No Was any monitoring equipinont 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* ❑ No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> C3 Product; Water, If yes,describe causes in Section E,below, <br /> 10 <br /> Yes [I No* Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports,if ap ticable <br /> Yes a No* is aU monitoring equipment operatiotwl per manufacturor's specifications? <br /> *In Section>E below,describe bow and when these deficiencies were or will be corrected. <br /> E. Comments: <br /> UN-OU-31f wrvw.aaidamorlt Rcv.01/17/08 <br /> S.d'd 22t?289b:01 96ZtiISS608 33N'dI-1dW03 0Sn:WOdd b2:60 t7Z02-82-dUW <br />