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D. Results of Testing/Servicing SEP 12 20116 <br /> Software Version Installed: NIA <br /> Complete the following checklist: <br /> Q Yes 171 No' Is the audible alarm operational? <br /> P] Yes El No' Is the visual alarm operational? <br /> ✓ Yes No' Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> E✓ 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 /> ® Yes No" If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem)operational? <br /> r <br /> NIA <br /> ® Yes No' For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system <br /> R, NIA detects a leak,fails to operate,or is electrically disconnected? If yes:which sensors initiate positive shut-down? (Check all that apply) <br /> ❑Sump/Trench Sensors: ❑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 property? If so,at what percent <br /> of tank capacity does the alarm trigger? 94 % <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 /> Yes' Q 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 /> EF,,IY s *No <br /> Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports,if applicable <br /> s 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 /> Visual verification of flapper on drop tube done. <br /> Also tested Vent box and transition sump ( LS 600). All good <br /> Monitoring System Certification Page 2 of 4 12107 <br /> 1) 2/21,107 <br />