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Monitoring System Certification-.Page 2 or 3 <br /> Site Address:_ 2905 W.Benjamin Holt Dr Date of Testing/Servicing: 7128/10 <br /> D. Results of Testing/Servicing <br /> Software Version Installed- 3Z-7,13,p <br /> Complete the foliowin checklist: <br /> FaNes <br /> ❑ No* Is the audible alarm operational? <br /> ❑ No* is the visual alarm operational? <br /> ❑ No* Were all sensors visually inspected,functionally tested,and confirmed o. rational? <br /> ❑ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br /> not interfere with their proper operation? <br /> W Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment(e.g.modem) <br /> ❑ NA operational? <br /> ❑ Yes ❑ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br /> 0 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 applti) ❑ Sumpfrrench Sensors: ❑ Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ❑ Yes ❑ No <br /> ❑ Yes ❑ No* For tank systems that utilize the monitoring system as the primary tonk overfill warning device(i.e. no <br /> ® N,A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br /> fill point(s)and operating properly? If so,at what percent of tank ctl•oacity does the alarm trigger? % <br /> ❑ Yes* IL 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 /> ❑ Yes* ❑ No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that applw <br /> ❑ Product;❑ Water. If yes,describe causes in Section E,below. <br /> ❑ Yes 1 ❑ No* I Was monitoring system set-up reviewed to ensure eroEr settin= ? (Attach set-up re orfs, i a licable. <br /> ❑ Yes ❑ No* Is all monitoring equipment operational per manufacturer's specifications? <br /> w In Section E below,describe how and when these deficiencies were or will be corrected. <br /> E. Comments: i s 1 s -97y fA U ^%a 52.An�'f'r G+'twi.P(L>n1_ f-C <br /> L�7 A 6-3 <br />