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Monitoring System Certification <br /> D.Resuid of Testing/Servicing <br /> Software Version Installed: 329.01 <br /> Complete the following_checklist: <br /> 0 Yes [3 No* Is the audible alarm operational? <br /> 0 Yes El No* Is the visual alarm operational? <br /> 0 Yes L3 No* Were all sensors visually inspected,fimctionally tested,and confirmed operational? <br /> C@ Yes [3 No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br /> not interfere with their proper operation!? <br /> 0 Yes 0 No*, If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) <br /> 0 N/A operational? <br /> 0 Yes 0 No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br /> [3 N/A monitoring system detects a leak,fails to operate,or is electrically disconnected? If yes:which sensors initiate <br /> positive shut-down? (Check all that apply) X Sump/Trench Sensors. 0 Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? x Yes; Q No, <br /> 0 Yes 0 No* For tank system that utilize the monitoring system as the primary tank overfill warning device (i.e., no <br /> [3 N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br /> fill point(s)and operating properly? if so,at what percent of tank capacity does the alarm trigger? 90% <br /> 0 Yes* 0 No Was any monitoring equipment replaced? If yes,identify specific sensors,probes,or other equipment replaced <br /> and list the manufacturer name and model for all replacement parts in Section E,below. <br /> El Yes* 0 No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> [3 Product; []Water. If yes,describe causes in Section E,below. <br /> 0 Yes r7l No* Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports,if applicable <br /> ER Yes 0 No* 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: THIS IS AS0 DOA EULL TEST QU 13-10 <br /> Page 2 of 3 <br /> F. In-Tank Ganging/SIR Equipment: r_3 Check this box if tank gauging is used only for inventory control, <br /> UN-4.46-2/4 www.unidoes.org Rev.01/26/06 <br /> coo z Nouvis ammas zq 09CZ TLC 9T6 YVA Tb:CT OTOZ/OT/ZO <br />