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Monitoring System Certification <br />Date of Testing/Servicing. <br />A Results of Testing/Servicing <br />Connflete the following cherWimrt- <br />O"Yft <br />* <br />❑ No* <br />Is the audible alarm o bona!? <br />O No* <br />Is the visual alarm oral? <br />O No* <br />Were all sensors visual functiOnallY tested, and confirmed rational? <br />Yes <br />O No* <br />Were all sensors installed at lowest point ofsecondary containment and positioned so that other equipment <br />will not interfere with their 'on? <br />® Yes <br />❑ * <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modern) <br />N/A <br />operational? <br />'Yes <br />p No* <br />O N/A <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />monitoring <br />system detects a leak, faits to operate, oris ectrically disconnected? yes: which sensors <br />initiate positive shut -down? <br />(Check all that apply) Sump/Trench Sensors; QDispenser Containment <br />Sensors. <br />Did you confirm positive shut -down due to leaks and sensor failure/disconnection? Yes; ❑ No. <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br />mechanical overfill prevention valve is installed), <br />El"Yes <br />❑ No* <br />O N/A <br />is the overfill warning alarm visible and audible at the tank <br />fill point(s) and operating properly? If so <br />p Yes* <br />o <br />at what nt of tank ca aci does the alarm tri ????% <br />Was any monitoring equipment replaced? If yes, identify specific <br />sensors, probes, or other equipment <br />replaced and list the manufacturer name and model for all T21acement parts in Section E, below. <br />CYYes* <br />0 No <br />Was liquid found inside any secondary containment systems designed as dry systems? (Check all that aFP1Y) <br />O Product' ❑ Water. If yes describe causes in Section E, below. <br />Q'Ve.s <br />© No* <br />Was TM Lorin stern Set- reviewed to ensure 2rTE settinCrYS? <br />es <br />-[],No* <br />Is all monitoring ui ment operationalper manufactimer's mer'frat;n„c9 <br />In Section E below, describe how and when these deficiencies were or will be corrected, <br />E. Comments: S� � ! � 3 � �°" r 7 S <br />