COMPLIANCE INFO_1991-2008 - Laserfiche WebLink

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Facility Name: Norms 76 / 8 / 01 — ate ut i estmgiServtctng: D. Results of Testing/Servicing Comnlete the fnitnwine rhaetttlef- 5P Yes (❑ No* Is the monitoring system o crational per manufacturer's specifications? ® Yes ❑ No* Is the audible alarm operational? 0 Yes ❑ No* Is the visual alarm operational" ® Yes ❑ No* Were all sensors visually inspected. tested and confirmed operational? W Yes ❑ No* Were all sensors and probes reinstalled ro erl ? 0 Yes ❑ No* Is all monitoring equipment secured from unauthorized tampering? ❑ Yes ❑ No* IX N/A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? 0 Yes ❑ No* If needed by any monitoring equipment, are replacement fuses and/or batteries available? ❑ N/A ❑ Yes CK No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment ❑ N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut -down? (Check all that apply) ❑ Sump/Trench Sensors; ❑ Dispenser Containment Sensors. Did you confirm positive shut -down due to leaks and sensor failure/disconnection? ❑ Yes; ❑ No. ❑ Yes ❑ No* IX N/A For monitoring systems that also serve as tank overfill warning devices, is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? %, ❑ Yes* lk No Was any monitoring equipment replaced? If yes, identifyspecific sensors P ,probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. ❑ Yes QC No Was any s stem software u graded? If yes, identify the new version number in Section E, below. ❑ Yes* ❑{ No Was liquid found inside any secondary containment systems? (Check all that apply) ❑ Product; ❑ Water. If es, describe causes in Section E. below. -• �. �.•..•.., vcavn' Ucacg Avc BMW ARAU Bruen u►ese ueuceenc►es were or will be corrected. E. Comments: Test all impact ( Shear) Valves -All O.K. 12 Total Page 3 of this Certification must be completed and attached only if one or more of the following conditions arc filet: 1.) rn- tank gauging equipment is used to perform leak detection monitoring; 2.) Line leak detectors are installed on piping systems: 3.) Completion is required by your local agency that regulates UST systems. CALd1-01 I'a e 2 l+ Oa