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E)1/02/19'35 03:27 20A746722 CAi AVERAS Enke . PALE 92 <br />'iRonilortug System Certification <br />FactlityNatna t✓.1�%� 12atcvt icttmgSrxvxcmg:� �3 <br />D_ Results of Testi icing <br />r <br />VI <br />Q No' <br />IS the monito ' s stens bona! tananufacmrcr's ifications?Q <br />Ne <br />is the audible &lam uotsal? <br />Q No• <br />is the visa:! alarm nal? <br />® No• <br />Were mil sensors test and coafarmed O Clonal? <br />0 No' <br />Wert all sensate and rotes reiasuiied r i ? <br />16 <br />D No• <br />Is an monitoria m Ott secured from uaanthorized ? <br />Q Ne <br />if aln= are relayed to a rctnoie monitoring station, is ail communications equipment (c.g. modem) <br />9 N/A <br />l? <br />Cl No* <br />If needed by any monitoring equipanent, are replacement flses anchor batterics available? <br />0 I+UA <br />$i Yes <br />Q No* <br />For pressurized piping systems, does the twbine automatically sbut down S- the piping ScCOAdaty containment <br />Q N/A <br />monitoring system detects a leak. fails to *permit, or is electrically disconnected? If yes. whiCh sensors initiate <br />positive shut-dowsO (Check all that appfy) ® SompfTremb Sensors; 8 Dispenser Contaiumeat Sccsors. <br />Did you coafum positive shut --downs due to leaks ad scum fmifurrldiseo=eel W- 0 Ycs: Q No. <br />Q Yes <br />Q No* <br />Far moniupriogsyztcms that also serve as tank overfill warning devices, is the overfill warming alum visible <br />M WA <br />and audible at the tank fah1 goings) and operating properly? If So. at what percent of tans; capacity does the <br />7tlitim 9 0% <br />Q Ycs• <br />19 No <br />Lilacs any moonofing equipmeor replaced? If yes, identify specific sensors, probes, of other equipment replaced <br />and list the nunufachater name and model for all r lacememt arta in Section E, below_ <br />Q Yes <br />as No <br />Was tem sofCw&m aded? If yes. ideas the new version numbcr i:r Section E. below. <br />Q Ycs• <br />0 No <br />Was liquid found inside any secondary eontaiumcnt systerns? (Check all char apply) O ProNet; Q Water. If <br />ya describe causes in Section E, below. <br />" In Section JK below, describe how arA when these deficiencies were or well be corrected- <br />Page 3 of tads Certification must be completed and actacbed only if one or more of the following eondkioni are suet: l_) In - <br />tank ganging equipment Is tied to perform leak detection monitoring; Z.j Liter leak detectors are installed as piplag sy6utns- <br />3.) CorrVictioa is reguired by your tocid agency that reetuates (1ST systems. <br />CAU"t Page 2 06tI3M <br />b d 2trE9— T 9t► (602) umo.ag a t ijeo d01r : Zo co co T nr <br />