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Monitoring System Certification-Page 2 of 3 <br /> Site Address: 1103S. Ma!nSt Date of Testing/Servicing: 1119/12 <br /> M Results of Testing J Servicing <br /> Software Version Installed- 330.00 <br /> Complete the foliowin' checklist: <br /> ig Yes o No* Is the audible mal? <br /> 0 Yes 11 NO* Is the visual alarm operational? <br /> 09 Yes 0 No* Were all sensors visually inspected,functionally tested,and confirmed 22erational? <br /> 00 Yes D No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br /> not interfere with their 2Loper operation? <br /> 9 Yes 0 No* If alarms are relayed to a remote monitoring station,is all communications equipment(e.g,modem) <br /> ci N/A I? <br /> N Yes 0 No* For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment <br /> ❑ N/A 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) 0 Sump/Trench Sensors; 0 Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? 3 Yes 0 No <br /> 0 Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.no <br /> o N/A mechanical overfill prevention valve is installed),is the overfill warning alarm visible and audible at the tank <br /> fill points)and operating properly? If so,at what percent of tank ca2acity does the alarm trigger? 0 % <br /> 0 Yes* CC No 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 /> 0 Yes* M No Was liquid found inside,any secondary containment systems designed as dry systems? (Check all that app-1y) <br /> 0 Product;0 Water. If yes,describe causes in Section E,below, <br /> 3 Yes 0 No* Was monitoring system set-up reviewed to ensure proper settings? (Attach set-up reports, if applicable.) <br /> Do Yes 0 No* Is 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 />