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Monitoring System Certification <br /> j .. <br /> D. Results of Testing/Servicing <br /> Software Version Installed: <br /> Cqmplete the following checklist: <br /> es ❑ No* Is the audible alarm operational? <br /> s ❑ No* Is the visual alarm operational? <br /> IF Y s ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> es ❑ 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 /> ❑ Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br /> Q"/N/A operational? <br /> iU,Af es ❑ No* For pressurized piping systems, does the turbine automatically shut down if th piping secondary containment <br /> ❑ N/A monitoring system detects a leak, fails to operratey�r is electrically discome d? If yes: I ich sensors initiate <br /> I� positive shut-down? (Check all that apply) L ump/Trench Sensors; ispenser tainment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? Yes; ❑No. <br /> ❑ Yes ❑ o* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br /> �/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 capacity does the alarm trigger? % <br /> Yes* ❑ o 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* Ur No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> ❑Product; ❑Water. If yes,describe causes in Section E,below. <br /> es ❑ No* Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports,if applicable <br /> Or Yes ❑ 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: q lv Z 70 A im . Q✓+ a w �n�1"zx ���° <br /> Page 2 of 3 03/01 <br />