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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM ( Page 4 of 6) <br /> Ulll . MONITORING SYSTEM AND PROGRAMMING <br /> This section must be completed if a monitoring panel is used to perform leak detection monitoring . Y N ' NA <br /> Are the visual and audible alarms operational ? r' r <br /> Were all sensors visually inspected for kinks and breaks in the cables and for residual buildup to ensure that floats <br /> move freely, functionally tested , and confirmed operational ? <br /> Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not �� r <br /> interfere with their proper operation ? <br /> Was monitoring system set-up reviewed to ensure proper settings? r r r <br /> Was the monitoring panel's backup battery visually inspected , functionally tested , and confirmed operational ? r r <br /> Does the flow of fuel stop at the dispenser if a leak is detected in the under-dispenser containment? r r <br /> Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operate or is r �— <br /> electrically disconnected ? <br /> Does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak? �— <br /> Which sensors initiate positive shut down? (Check all that apply.) [vl Sum lV Under-dispenser containment <br /> If alarms are relayed to a remote monitoring station , is all communications equipment (e. g . modem) operational ? L.r r <br /> For any answer of "N " above, describe in section IX how and when these deficiencies were or will be corrected. <br /> IX COMMENTS <br /> Use this section to provide any additional comments about the inventory of the equipment certified. <br /> X IN-TANK GAUGING TESTING <br /> r Check this box if tank gauging is used only for inventory control . (Do not complete this section .) <br />' r Check this box if NO tank gauging equipment is installed . (Do not complete this section.) Y N NA <br /> This section must be completed if in-tank gauging is used to perform leak detection monitoring. <br /> Has all input wiring been inspected for kinks and breaks in the cables and for proper entry and termination , including r- r - <br /> testing for ground faults? <br /> Were all in-tank gauging probes visually inspected for damage and residue buildup to ensure that floats move freely, <br /> functionally tested , and confirmed operational ? <br /> Was accuracy of system' s product level readings tested ? <br /> Was accuracy of system' s water level readings tested? �' r r <br /> Were all probes reinstalled properly? rv ' r (- <br /> Were all items on the equipment manufacturer's maintenance checklist completed? r r <br /> For any answer of "N " above, describe in section XI how and when these deficiencies were or will be corrected. <br /> XI. COMMENTS <br /> Use this section to provide any additional comments about the inventory of the equipment certified. <br /> Y = Yes , N = No , NA = Not Applicable <br />