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Software Version Installed: o 9 t <br />Conlydetei the folinwina rherklict- <br />Yes <br />❑ No* <br />Is the audible alarm operational? <br />D Yes <br />❑ No* <br />Is the visual alarm operational? <br />LkYes <br />❑ - No* <br />Were all sensors visually inspected, functionally tested nand confirmed operational? <br />Yes <br />❑ No* <br />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 />❑ Yes <br />❑ No* <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br />N/A <br />operational? <br />❑ es <br />❑ No* <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />❑ N/A <br />monitoring system detects a leak, fails to operale, or is electrically disconnected? If yes: which sensors initiate <br />positive shut -down? (Check all that apply) Aump/Trench Sensors; Dispenser C ntainment Sensors. <br />Did you confirm Positive shut -down due to eaks and sensor failure/di connection? Yes; ❑ No. <br />❑ Yes <br />No* <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br />❑ N/A <br />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? <br />❑ Yes* <br />No <br />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 re lacement p2rts in Section E, below. <br />❑ Yes* <br />No <br />Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br />❑ Product; ❑ Water. If yes, describe causes in Section E, below. <br />Yes <br />❑ No* <br />Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable <br />r es <br />❑ No* <br />Is all monitorin a ui mentoperational per manufacturer's specifications? <br />in aecrion r, oejow, oescrine now ana wnen tnese deficiencies were or will be corrected. <br />E. Comments: 0 l f\(OV-f <br />Page 2 of 3 03/01 <br />