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E ED <br /> ' 82 0 i'? <br /> D. Results of Testing/Servicing <br /> ENVIRONMENTAL HEALTH <br /> Software Version Installed. V200091 <br /> DEPARTMENT <br /> Complete the following checklist: <br /> 2 Yes El No* Is the audible alarm operational? <br /> P71 Yes El No* Is the visual alarm operational? <br /> Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> El Yes No" Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their <br /> proper operation? <br /> 171 Yes No* If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem)operational? <br /> N/A <br /> El Yes No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system <br /> ✓ NIA detects a leak,fails to operate,or is electrically disconnected? If yes:which sensors initiate positive shut-down? (Check all that apply) <br /> n Sump/Trench Sensors: [3 Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor <br /> failure/disconnection?[]Yes; No. <br /> Yes No' For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e. no mechanical overfill prevention <br /> N/A valve is installed),is the overfill warning alarm visible and audible at the tank fill point(s)and operating properly? If so,at what percent <br /> of tank capacity does the alarm trigger? 90 % <br /> Yes* Q No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the <br /> manufacturer name and model for all replacement parts in Section E,below. <br /> E] Yes- No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply)[]Product;[]Water. If <br /> es,describe causes in Section E,below. <br /> ✓ Yes No' Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports,If applicable <br /> Ua-Yr TJ­No` 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: <br /> Also tested vent box and transition box sensors, both LS-600. passed and certified, <br /> Also verified overfill valve on drop-tube. <br /> Monitoring System Certification Page 2 of 4 12/07 <br /> 1) 2/21/07 <br />