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Monitoring System Certification - <br /> � �/ 57 � <br /> ..Site Address:. L� LO&.4 s S � /n'�'V� Date ofresiing/Sexvicing: <br /> D. Results of Testing/Servicinig. <br /> Software Version Installed t �,.O57- <br /> Complete the following checklist: <br /> es ❑ No* Is the audible alarm operational? <br /> Yes • ❑ Not .Is the visual alarm operJdOm l? <br /> Yes ® NO Wen all•sensors visually functionally tested,and confirmed operational? <br /> Aryes : ❑ Nos Were all sensors installed at lower£point of secondary containment and positioned so tliat other equipqat� <br /> not interfere with their proper operation? . <br /> O Yes C3 No* If alarm arc relayed to a remote monitoring statidn, is.all communications eluipmeat (erg- modem)' " <br /> A opmdonal? , <br /> _ es . ❑ Nos ]For premized,piping systems,does the turbine automatically shut down if the piping secondary containment <br /> s ® N/A monitoring system detects a leak,fans to opeatc,.or is electrically disconnected? If yes: which sensors initiate <br /> positive shut-down? (Checkall that apply) . p/Trench Sensors; Cl Dispenser Containment Sensors,. <br /> - 'Did you confirm positive shut-down due to leaks and sensor failureldiscoimection?Za-y s;_�q No. <br /> -0Yes 0 No* For-tank systems that utilize-the monitoring system*as-the primary tank*overfill warning 4evice (Le.-no <br /> mechanical overfill prevention-valve is installed),is the overfill warning <br /> alarm visible and audible at thZ tank. <br /> : fill points)and ogcratiag properly?..If sq at what of tank capacity does the alarm trigger"? <br /> •O"•Yes' : "0- Was any mgnitor ing equipment replaced? If yes,identify specific sensors,probes,orother equipment replaced- <br /> and list the manufacorrer name and model for all replacement parts in Saxton E,below:.. . <br /> • O YeSs o . Was liquid found inside any secondary eat sjistems designed at dry systems? ( all that apPl3) ' <br /> ❑Product; ❑Wabes::Ifyes, causes jaSedion,lE;below.. <br /> Yes. O otos" Was system set-up reviewed to ensues proper <br /> 'Yes ❑'Nos Is altm eutoperational permoa s ris? , <br /> *In Section E below;describe hoar and when these deficiencies were or will he corrected. <br /> Comments• ' <br /> CAI,N4-0i Page 2.of 3 r 1/15/99 <br />