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UNDERGROUND STORAGE TANK MONITORING SYSTEM CERTIFICATION FORM (Pages 4 of s) VIII . MONITORING SYSTEM AND PROGRAMMING This section must be completed if a monitoring panel is used to perform leak detection monitoring. Y N NA Are the visual and audible alarms operational? © ❑ ❑ Were all sensors visually inspected for kinks and breaks in the cables and for residual buildup to ensure that floats move freely, ❑ functionallt tested, and confirmed operational? Were all sensors Installed at lowest point of secondary containment and positioned so that other equipment will not interfere with HEItheir ro er o eration ?Was monitoring system set-up reviewed to ensure proper settings? ❑ Was the monitoring panel's backup battery visually inspected , functionally tested, and confirmed operational? ® ❑ ❑ Does the flow of fuel stop at the dispenser if a leak is detected in the under-dispenser containment? u ❑ ❑ Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operate or is electrically © ❑ ❑ disconnected? Does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak? ❑ ❑ ❑ Which sensors initiate positive shut down? (Check all that apply.) Z Sump ® Under-Dispenser Containment If alarms are relayed to a remote monitoring station, is all communications equipment (e. g . , modem) operational? Q ❑ ❑ For any answer of "N" above, describe in Section IX how and when these deficiencies were or will be corrected. IX. COMMENTS Replaced TLS Battery for PM Purpose , I C I I i i I i E X. INJANK GAUGING TESTING ❑ Check this box if tank gauging is used only for inventory control. (Do not complete this section .) F1Check this box if NO tank gauging equipment is Installed . (Do not complete this section.) Y N NA This section must be completed if in-tank gau ing Is used to perform leak detection monitoring. Has all input wiring been inspected for kinks and breaks in the cables and for proper entry and termination , including testing for ® ❑ ❑ round faults? Were all in-tank gauging probes visually inspected for damage and residue buildup to ensure that floats move freely , functionally ❑ ❑ ❑ tested , and confirmed operational? Was accuracy of system's product level readings tested ? ® ❑ ❑ Was accuracy of system's water level readings tested? [� ❑ ❑ Were all probes reinstalled properly? ® ❑ ❑ Were all items on the equipment manufacturer's maintenance checklist completed ? Q ❑ ❑ For any answer of "N" above, describe in Section Xl how and when these deficiencies were or will be corrected. XI . COMMENTS Y = Yes, N = No, NA = Not Applicable