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Monitoring System Certification <br /> i <br /> A Results of Testing/Serviciug <br /> Software Version Jnstalled: <br /> Conn fete the followin checklist: <br /> Yes Q No* is the audibib alarm operational? <br /> K1 Yes ❑ No* is the visual alarm operationall <br /> and confirmed operational? <br /> yes p Ido* Were all sensors visually inspected,fuvctxonally tested,containment and positioned so that other equipment will. <br /> Yes p Ito# Were all sensors installed at lowest point of secondary <br /> es. <br /> not interfere with their Proper operation? S q e modem.) <br /> ❑ <br /> yes El No* If alarms are relayed to a remote monitoring station, is all countnwicationsa uipment { .g., <br /> 1�, operational? <br /> Yes [] No* For pressurized If <br /> piping systems, does the tiubine automatically shut down.if the piping secondary c 11 ort imtlatt <br /> ❑ NIA. monitoring system deteetg a leak,fails hich sens <br /> to operate,or is electrically discozuDiseenser Cont Winment Senasne <br /> ors�tia } <br /> positive shut-down? (Check all that apply) X SwnprTren-h Sensors; �1 p <br /> Did you conf=positive shut-down due to leaks aid_sensor failureldisconnection? Wy ; C1 No <br /> st <br /> s em as the primary tonic overfill wart�kg device (i.e.. no <br /> Yes El No* For tank. systetus that utilize the monitoringy <br /> (I NIA mechanical overfill prevention valve is installed), is the overfill wanting alarm visible and audible at thetank <br /> fill points)and.operating roperly? If so,at what percent o£tank capacity does the alarm trigger? <br /> ye;* {� 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 ,below. <br /> [] Yes* ( No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> E]Product, ❑Water. If yes,describe causes in Section F,below. reports,if applicable <br /> Yes ❑ No* Was monitoring system.set-t?p reviewed to ensure proper settings?Attach set up <br /> Yds p No* la all monitor*equipment operational mnufacturer's specifications? <br /> *In Section E below,describe)tow and when these deficiencies were or will be corrected. <br /> F. Comments: <br /> ����� Zllh �eL1 � �G✓� <br /> UN,036-3/6 www.anidemorg Rev.01/17/03 <br />