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19255517888 Main Fax GETTLER RYAN INC <br />d Monitoring System Certification <br />' A Results of Testing/Servicing <br />Software Version Installed: 3 • O <br />Complete the following checklist: <br />7:49 p.m. 02-01-2007 419 <br />III <br />-1910 0 <br />Yes <br />❑ No* <br />Is the audible alarm operational? <br />Yes <br />❑ No* <br />Is the visual alarm operational? <br />❑ Yes <br />o* <br />Were all sensors visually inspected, functionally tested, and confirmed operational? <br />Yes <br />❑ No* <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br />not interfere with their proper operation? <br />PNYes <br />❑ No* <br />if alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br />❑ N/A <br />operational? <br />Yes <br />❑ No* <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />❑ N/A <br />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) jSump/Trench Sensors; ❑Dispenser Containment Sensors. <br />Did you confirm positive shut -down due to leaks and sensor failure/disconnection? es; ❑ No. <br />Yes <br />❑ No* <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br />❑ N/A <br />mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br />fill points) and operating properly? If so, at what percent of tank capacity does the alarm trigger? % <br />Yes* <br />❑ No <br />=0 <br />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 replacement parts in Section E, below. <br />❑ Yes*o <br />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 />Yes <br />❑ No* <br />Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable <br />'DCyes <br />❑ No* <br />Is all monitoring equipment operational per manufacturer's specifications? <br />* In Section E below, pescrene now ana wren mese aenceencees were or wen pe correctea. <br />E. Comments: `� 91 0,.11 Sv M.,p a ea.s a i- W dA. <br />Page 2 of 3 03101 <br />