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RECEIVED <br /> 0 C T 08 2013 <br /> D.Results of Testing/Servicing <br /> Software Version Installed: none ENVIRONMENTAL <br /> HEALTH <br /> Complete the following checklist: <br /> ro Yes =; No* Is the audible alarm operational? <br /> Yes r No* Is the visual alarm operational? <br /> ,,, Yes mNo* Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> Yes * No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere wit <br /> heir proper operation? <br /> Yes ' No* If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem)operational? <br /> '+ N/A <br /> Yes No* For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment monitoring <br /> N/A stem detects a leak,fails to operate,or is electrically disconnected?If yes:which sensors initiate positive shut-down?(Check <br /> all that apply)r,Sump/Trench Sensors; r Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection?r Yes; r No <br /> Yes r No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.no mechanical overfill <br /> prevention valve is installed),is the overfill warning alarm visible and audible at the tank fill point(s)and operating properly?If <br /> `r' N/A so,at what percent of tank capacity does the alarm trigger? <br /> Yes* ,w' No as any monitoring equipment replaced?If yes,identify specific sensors,probes,or other equipment replaced and list the <br /> manufacturer name and model for all replacement parts in Section E below. <br /> Yes* o No as liquid found inside any secondary containment systems designed as dry systems?(Check all that apply) <br /> Product: r Water.If yes,describe causes in Section E below. <br /> ro Yes `' No* Fs <br /> s monitoring system set-up reviewed to ensure proper settings?Attach set up reports,if applicable <br /> Yes No* all monitoring equipment operational per manufacturer's specifications? <br /> *In Section E below,describe how and when these deficiencies were or will be corrected. <br /> E.Comments: <br /> The Owens and the prefered monitors are light and buzzer only no printer <br /> Monitoring System Certification Page 2 of 3 12/07 <br /> it <br />