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�e <br /> ® D. Results of Testing/Servicing <br /> Software Version Installed: Z",/4'' <br /> Co fete the following checklist: <br /> erWs ❑ No* Is the audible alarm operational? <br /> ❑ No* Is the visual alarm operational? <br /> FXF <br /> E3No* Wereall sensors visual/ ins ted,functional/ tested,and confirmed o erational? <br /> ❑ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br /> not interfere with their ro r o ration? <br /> ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br /> 13N/A operational? <br /> ❑ No* For pressurized_piping systems, does the turbine automatically shut down if the piping secondary containment <br /> ❑ N/A monitoring system detects a leak,fails to operate is electrically disconnected? If�Yes; <br /> hich sensors initiate <br /> positive shut-down? (Check all that apply) ump/Trench Sensors; ❑Dispenser ment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ❑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 int(s)and operating rorl ? If so,at what percent of tank caeacity does the alarm trigger? % <br /> ❑ Yes* Pr No Was any monitoring equipment replaced? If yes,identify specific sensors,probes,or other equipment replaced <br /> and Iist the manufacturer name and model for all replacement 2arts in Section E,below. <br /> ❑ Yes* No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply)❑ <br /> Product; ❑Water. If yes,describe causes in Section E,below. <br /> ❑ No* Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports,if applicable <br /> VY—es ❑ No* Is all monitoring ui ment operational per manufacturer's specifications? <br /> *In Section E below,describe how and when these deficiencies were or will be corrected. <br /> I---- <br /> E. Continents: 5171-- i s / T S�1a �� � Z 5,0 <br /> Page 2 of 3 03101 <br />