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f.+„nu.u', ,,� J��ll'llt 1,ef llt►IaLIU►1 <br />Facility Name: Norms 76 <br />D. Results of Testing/Servicing <br />Cntnntrtr thr (MI—i— rh.,L Hi t - <br />Date w iesting,iervfcing: 6 /_4 /02 <br />M Yes <br />❑ No* <br />Is the monitoring system operational per manutacturer's specifications? <br />M Yes <br />❑ No* <br />Is the audible alarm operational'? <br />Yes <br />❑ No* <br />Is the visual alarm operational'? <br />® Yes <br />❑ No* <br />Were all sensors visuallv inspected, tested, and confirmed operational? <br />M Yes <br />❑ No* <br />Were all sensors and probes reinstalled properly? <br />Yes <br />❑ No* <br />Is all monitorins, equipment secured from unauthorized tamperror ? <br />❑ Yes <br />O No* <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br />U N/A <br />operational'? <br />M Yes <br />❑ No* <br />If needed by any monitoring equipment, are replacement fuses and/or batteries available? <br />❑ N/A <br />❑ Yes <br />YX 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) ❑ Sump/Trench Sensors; ❑ Dispenser Containment Sensors. <br />Did you confirm positive shut -down due to leaks and sensor failure/disconnection? ❑ Yes; ❑ No. <br />❑ Yes <br />❑ No* <br />For monitoring systems that also serve as tank overfill warning devices, is the overfill warning alarm visible <br />XX N/A <br />and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capacity does the <br />alarm trigger? % <br />J Yes* <br />U No <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 />❑ YesZ <br />No <br />Was any system software u graded? If yes, identifv the new version number in Section E, below. <br />❑Yes* <br />) No <br />Was liquid found inside any secondary containment systems? (Check all that apply) ❑ Product; ❑ Water. If <br />es, describe causes in Section E. below. <br />-t oruti i. n ueiow, aescrr®e now ana when these deficiencies were or will be corrected. <br />E. Comments: Tested 12 Shear Valves—O.K. <br />Drop Tubes 3" to 6" off bottom of tanks <br />Regular Mech. Line Leak Detector failed test. <br />Page 3 of this Certification must be completed and attached on1v if one or more of the following conditions are met: 1.) In - <br />tank gauging equipment is used to perform leak detection monitoring; 2.) Line leak detectors are installed on piping sys(enis: <br />3.) Completion is required by your local agency that regulates UST systems. <br />CALIN1dlI <br />Page 2 <br />