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01/30/2003 09:12 818 929 TRIANGLE PAGE '-02 <br /> D. Results of Testing/Servicing <br /> Software Version InStal)ed: <br /> Co to the Milo ng checklist: <br /> ❑ No* Is the audible alarm operational? <br /> cs ❑ No* Is the visual Harm erationai? <br /> Yes O No, Were all censors visuallyin ted,functional) tested,and cWfirmed operational? <br /> ❑ Y'-- No" Were an Sensors installed at lowest point of secondary containment and positioned en that other equipmont]- <br /> 0 <br /> not interfere with their r tion? <br /> I' ❑ o* if alarms are relayed to a remote monitoring station, is all communiev;6ns equipment (e.g. modcm) <br /> N/A operational? <br /> CIS <br /> O Nor For pressurized piping systems,does the turbine automatically shut down ' the piping secondary containment <br /> ❑ N/A monitoring system detects a leak,fails to operate,or is electrically disco ected? If yes-which sensor,initimc <br /> Msitivc shut-down? (Check eX that apply) 19 Sumpt7rench Sensors; ' ,Dispenser Conraintttcnt Senstuq. <br /> Did ou confirm sitivc shut-down due to leaky and sensor failutc/disconnection? eq; Q No. <br /> ❑ Yes ❑ N * For tank systems that utilize, the monitoring syitztn as the primary tank ovo� roaming device (i.e. t>90 <br /> l <br /> /A mechanical overfill prevention valve is instAcd), iS the ove�ll warning alarm visible and audible at the Link <br /> fill int s and n rl ? if so,at what percent.of tank capacity does the alarm tri er? <br /> ❑ Yes* W No Was any monitoring equipment replaced? If yes,identify specific sensors,probes.or other equipment replaced <br /> and lest the manufacturer name and model for all=placement oarts in Section G below. <br /> ❑ Ycst No Was liquid found inside any Secondary contai»meat systems designed a.9 dry systema? (Check all that apply)❑ <br /> Product; ❑Water. If describe causes in Section E below. <br /> ❑ No" Was monitoring!Istemsct-UP reviewed to ensure ro r setti s?Attach set u"re if a licable <br /> Yes Q No* is all monitoringui ent o emtional manufacturer's, ifacadons? <br /> In Section E below,describe how and when thence deficiencies were or wig be corrected. <br /> E. Comments: A/ <br /> Sl/�f9 + b dT /M <br /> Page 2 of 3 nsm 1 <br />