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11 <br />Monitoring System Certification - Page 2 of 3 <br />Site Address: 35 N. Cherokee Ln. <br />D. Results of Testing / Servicing <br />Software Version Installed. 122.00 <br />Complete the fallowing checklist: <br />v <br />Date of Testing/Servicing: 11/29/12 <br />0 Yes <br />® No* <br />Is the audible alarm operational? <br />❑ Yes <br />0 No* <br />is the visual alarm operational? <br />13 Yes <br />0 No* <br />Were all sensors visually inspected, functionally tested, and confirmed operational? <br />13 Yes <br />0 No* <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br />not interfere with their pr2per operation? <br />❑ Yes <br />❑ No* <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br />® N/A <br />operational? <br />❑ Yes <br />❑ No* <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />0 N/A <br />monitoring system detects a leak, fails to operate, oris electrically disconnected? If yes: which sensors initiate <br />positive shut -down? (Check all that apply) ❑ Sump/Trench Sensors; ❑ Dispenser Containment Sensors. <br />Did you confirm positive shut -down due to leaks and sensor failure/disconnection? ❑ Yes ❑ No <br />❑ Yes <br />❑ No* <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br />IN N/A <br />mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br />fillpoint(s) and o erating properly? If so, at what percent of tank cVacLty does the alarm trigger? 0 % <br />❑ Yes* <br />0 No <br />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 />D Yes* <br />H No <br />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 />❑ Yes <br />1 No* I <br />Was monitoring system set-up reviewed to ensure Eroper settings? Attach set -!E re orts, t a livable. <br />❑ Yes <br />C1 Na* <br />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: Monitor Certification performed for Permit Final due to replacement of Diesel Mech Leak <br />Detector. <br />