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UNDERGROUND STORAGE TANK MONITORING SYSTEM CERTIFICATION FORM (Page 4 of s) VIII. MONITORING SYSTEM AND PROGRAMMING This section must be completed If a monitoring panel is used to perform leak detection monitoring. Y N I NA Are the visual and audible alarms operational? © ❑ ❑ Were all sensors visually inspected for kinks and breaks in the cables and for residual buildup to ensure that floats move freely, functional) tested, and confirmed operational? 1:1 ❑ Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? ® ❑ ❑ Was monitoring system set-up reviewed to ensure proper settings? ❑ ❑ ❑ Was the monitoring panel's backup battery visually inspected, functionally tested, and confirmed operational? ® ❑ ❑ Does the flow of fuel stop at the dispenser if a leak is detected in the under -dispenser containment? W1❑ Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operate or is electrically disconnected? 91 ❑ ❑ Does the turbine automatically shutdown if the piping secondary containment monitoring system detects a leak? Which sensors initiate positive shut down? (Check all that apply.) W1 SumUnder-Dispenser❑ Sump Containment ❑ ❑ If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) operational? m ❑ ❑ For any answer of "N" above, describe in Section IX how and when these deficiencies were or will be corrected. IX. COMMENTS Replaced TLS Battery for PM Purpose. X. IN -TANK GAUGING TESTING Check this box if tank gauging is used only for inventory control. (Do not complete this section.) ❑ Check this box if NO tank gauging equipment is installed. (Do not complete this section.) This section must be completed if in -tank gauging Is used to perform leak detection monitoring. Y N NA Has all input wiring been inspected for kinks and breaks in the cables and for proper entry and termination, including testing for faults? ❑ Elround El Were all in -tank gauging probes visually inspected for damage and residue buildup to ensure that floats move freely, functionally tested, and confirmed operational? E] E]❑ Was accuracy of system's product level readings tested? El ❑ ❑ Was accuracy of system's water level readings tested? ❑ ❑ ❑ Were all probes reinstalled properly? ❑ ❑ ❑ Were all items on the equipment manufacturer's maintenance checklist completed? ❑ For any answer of "N" above, describe in Section XI how and when these deficiencies were or will be corrected. XI. COMMENTS Y= Yes, N = No, NA = Not Applicable