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Monitoring system Certification <br />Site Address: <br />D. Results of Testing/Servicing <br />Software Version Installed: <br />Date of Testing/Servicing: <br />Co fete <br />the foHoMng <br />checklist: <br />es <br />❑ No* <br />Is the audible alarmoral? <br />❑ No* <br />Is the visual alarm rational? <br />❑ No* <br />Were all sensors visual functionally tested, and confirmedoperational? <br />Yes <br />D No* <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment <br />will not interfere with their gIgn 2R92on? <br />❑ Yes <br />❑ * <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br />Ef N/A <br />operational? <br />es <br />❑ No* <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />D N/A <br />monitoring system detects a leak, fails to operate, or is plecthically disconnected? jf, yes: which sensors <br />Dispenser Containment <br />initiate positive shut -down? (Check all that apply) ET SamplTrench Sensors; <br />Sensors. �' <br />Did you confirm positive shut -down due to leaks and sensor failure/disconnection? Q Yes; ❑ No. <br />es <br />D No* <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br />r <br />[3 N/A <br />mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br />- <br />fill int s and ratio t ? If so at what t of tank does the alarm trigger? ????%Rs <br />Yes* <br />p No <br />Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment <br />laced and list the manufacturer name and model for all replacement in Section E, below. <br />D Yes* <br />No <br />Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br />❑ • ❑ Water. If Les, describe causes in Section E, below. <br />es <br />D No* <br />Was monitoringstent set- reviewed to ensure settin ? <br />Yes <br />D No* <br />Is all monitoring ui ment 2ppELtional per manufacturer's cations? <br />* In Section <br />E below, describe bow and when these deficiencies were or will be corrected. <br />E. Comments: 91 p vIn a j a r S"521- wO U U Inde" j2 P idl A e e co'l <br />