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MAR-21-2012 12:23 Service Station Systems 408 938 8888 P.04 <br /> Monitoring System Certification-Page 2 of 3 <br /> Site Address: 401 W. Kettleman Ln. Date of Testing/Scrvicing: 2/23/12 <br /> D. Results of Testing/Servicing <br /> Software Version Installed- 122.00 <br /> Com lets the following checklist: <br /> M Yes Q No* is the audible alarmoperational? <br /> ® Yes ❑ No* Is the visual alarm operational? <br /> 0 Yes 0 No* Were all sensors visual) ec <br /> ins ted,functionally tested,and confirmed operational? <br /> 9 Yes Q No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br /> not interfere with theirprgper operation? <br /> a Yes ❑ No* If alarms arc relayed to a remote monitoring;station,is all communications equipment(e.g.modem) <br /> 0 N/A operational? <br /> a Yes Q No* For pressuri7ed piping systems,does the turbine automatically shut down if the piping secondary containment <br /> ❑ N/A monitoring system detects a leak,fails to operate,or is electrically disconnected? If yes:which sensors initiate <br /> positive shut-down? (Check all that apply) ® Sump/"french Sensors; Q Oispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor tailurc/disconnection? ® Yes ❑ No <br /> ❑ Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(Le,no <br /> a 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 property? If so,at what percent of tank capacity does the alarm tri er? 0 <br /> 0 Yes* M 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 re lacement parts in Section r,below. <br /> ❑ Yes* K No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply.) <br /> ❑ Product;Q Water. if yes,describe causes in Section B.below. <br /> 0 Yes 0 No* Was monitoring system set-u2reviewed to ensure proper settings? Attach set-u re orfs. i alicahle. <br /> ® Yes ❑ No* Is all monitoring equipment operational per manufacturer's specifications? <br /> *In Section E below,describe how and when these deficiencies were or will he corrected, <br /> E. Commeab. Per Inspector-probes did not need to be tested due to site having flapper valves. <br /> Dispenser 5-6,7-8 floats did not trip shear valve.Adjusted on site with Inspector.Tested ok. <br />