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9e' 517888 Line 1 <br />0AINCIF <br />. <br />A. Results of Testing/Servicing <br />Software Version Installed: 130.01 <br />Comolete the following checklist: <br />14:53:30 09-11-2014 3/4 <br />GR Job # 20»602042 <br />f Yes <br />❑ Ne <br />Is the audible alarm operational? <br />ff Yes <br />❑ No" <br />Is the visual alarm operational? <br />[j Yes <br />❑ No' <br />Were all sensors visually inspected, functionally tested, and confirmed operational? <br />ff Yes <br />[l No" <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not Interfere with their <br />roer o eration? <br />❑ Yes <br />[3 N/A <br />9 alarms are relayed to a remote monitoring station, is all communication equipment (e.g. modem) operational? <br />( Yes <br />❑ No" <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system <br />WA <br />detects a leak, fails to operate, or Is electrically disconnected? If yes: which sensors initiate positive shut -down? (Check all that apply) <br />❑ Sump/Trench Sensor, ❑ Dispenser Containment Sensor. Did you confirm positive shut -down due to leaks and sensor <br />failureldisconnection? ❑ Yes; ❑ No. <br />(y Yes <br />[) No" <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no mechanical overfill prevention <br />17 NIA <br />valve Is installed} is the overfill warning alarm visible and audible at the tank fill point(s) and operating property? If so, at what percent <br />of tank capacity does the alarm trigger? ---!0—% <br />❑ Yes <br />E No <br />Was 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 <br />JZ No <br />Was liquid found Inside any secondary containment systems designed as dry systems? (Check all that apply) ❑product; ❑ Water. If <br />yes, describe causes In Section E, below. <br />rX Yes <br />[j No" <br />Was monitoring system set-up reviewed to insure proper settings? Attach set-up reports, if applicable. <br />Ig Yes <br />❑ No" <br />I Is all monitoring equipment operational per manufacture's specifications? <br />••• .....•.,•,•............, .....,....,.� ...... o,,,., n..a., ...vao vcnv,w,a.,eo rrc,c w ons ua a.m sea.aee- <br />E. Comments: <br />Monitoring System Certification Page 2 of 4 <br />2 <br />12ID7 <br />