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D. Results of Testing/Servicing <br />Software Version Installed: <br />Complete the following checklist: <br />RECEIVED <br />OCT 25 2013 <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />• Yes <br />r No* <br />Is the audible alarm operational? <br />• Yes <br />r No* <br />Is the visual alarm operational? <br />• Yes <br />r No* <br />Were all sensors visually inspected, functionally tested, and confirmed operational? <br />• Yes <br />r No* <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with <br />heir proper operation? <br />Yes <br />r No* <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? <br />* N/A <br />• Yes <br />r No* <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring <br />system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut -down? (Check <br />N/A <br />all that apply) r Sump/Trench Sensors; r Dispenser Containment Sensors. <br />Did you confirm positive shut -down due to leaks and sensor failure/disconnection? r Yes; r No <br />Yes <br />r No* <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no mechanical overfill <br />prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly? If <br />• N/A <br />so, at what percent of tank capacity does the alarm trigger? % <br />Yes* <br />* No <br />Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the <br />manufacturer name and model for all replacement parts in Section E below. <br />Yes* <br />• No <br />Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br />Product; r water. If yes, describe causes in Section E below. <br />ro Yes <br />r No* <br />Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable <br />• Yes <br />r No* <br />Is all monitoring equipment operational per manufacturer's specifications? <br />* In Section E below, describe how and when these deficiencies were or will be corrected. <br />Monitoring System Certification Page 2 of 3 12/07 <br />