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Monitoriug System Certification REC ]VED eco NOV 2 0 2015 (GO-C111.COWAIANC[ D. Results of Testing/Servicing ENVIRONMENTAL Software Version Installed: 333.02 HEALTH DFPARTMFNT Complete the following checklist: E Yes ❑ No* Is the audible alarm operational? E Yes ❑ No* Is the visual alarm operational? E Yes ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? E Yes ❑ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? ❑ Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) E N/A operational? ® l cs ❑ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment ❑ N/A monitoring system detects a leak, fails to operate,or is electrically disconnected? If yes:which sensors initiate positive shut-down? (Check all that apply) E Sump/Trench Sensors; E Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? E Yes; ❑No. E Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e.' no ElN/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s)and operating properly? If so,at what percent of tank capacity does the alarm trigger? 90% ❑ Yes* E No Was any monitoring equipment replaced? If yes,identify specific sensors,probes,or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E,below. E Yes* ❑ No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) ❑Product; E Water. If yes,describe causes in Section E,below. E Yes ❑ No* Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports,if applicable E Yes ❑ No* 1 Is all monitoring equipment operational per manufacturer's specifications? x In Section E below,describe how and when these deficiencies were or will be corrected. �r ( -� E. Comments: Small amount of water was found in both diesel STP sumps and the water was removed during the inspection.Addition 36he following equipment is connected to the rponitoring system: 1.Veeder Root—794380-304 Sensor monitoring the 87 Piping Sump Annu a 2.Veeder Root—794380-304 Sensor monitoring the 91 Piping Sump Annu lar 3.Veeder Root—794380-304 Sensor monitoring the Diesel Piping Sum Annu ar 4.Veeder Root—794380-304 Sensor monitoring the 87 Fill Sump Annu ar 5.Veeder Root—794380-304 Sensor monitoring the 91 Fill Sump Annu lar 6.Veeder Root—794380-304 Sensor monitoring the Diesel Fill Sump Annu lar. 7.Veeder Root—794380-304 Sensor monitoring the Under Dispenser Containment#1/2 Annua ar 8.Veeder Root—794380-304 Sensor monitoring the Under Dispenser Containment#3/4 Annualar 9. Veeder Root—794380-304 Sensor monitoring the Under Dispenser Containment#5/6 Annualar 10. Veeder Root—794380-304 Sensor monitoring the Under Dispenser Containment#7/8 Annualar 11.Veeder Root—794380-304 Sensor monitoring the Under Dispenser Containment#9/10 Annualar 12.Veeder Root—794380-304 Sensor monitoring the Under Dispenser Containment#11/12 Annualar 13.Veeder Root—794380-304 Sensor monitoring the Vent Sump Annular 14.Veeder Root—794380-304 Sensor monitoring the Vent Sump-All additional sensors were tested. Page 3 of 6