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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM Pa e 4 of 6 <br /> Vlll. MONITORING SYSTEM AND PROGRAMMING <br /> This section must be completed If a monitoring panel is used to perform leak detection monitoring. Y N NA <br /> Are the visual and audible alarms operational? Q ❑ ❑ <br /> Were all sensors visually inspected for kinks and breaks in the cables and for residual buildup to ensure that floats move freely, Q El El <br /> tested and confirmed operational? <br /> Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their El Elro er o eration? <br /> RI Was monitoring system set-up reviewed to ensure proper settings? Q ❑ ❑ <br /> Was the monitoring panel's backup battery visually inspected,functionally tested and confirmed operational? Q ❑ ❑ <br /> Does the flow of fuel stop at the dispenser if a leak is detected in the under-dispenser containment? ❑ <br /> Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operate or is electrically Ll Ll Q <br /> disconnected? <br /> Does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak? <br /> Which sensors Initiate positive shut down? (Check a0 that apply,) Sum ❑Under-dispenser containment ❑ ❑ Q <br /> If alarms are relayed to a remote monitoring station is all communications equipment(e.g.modem)operational? ❑ ❑ Q <br /> For anV answer of"N"above describe in section IX how and when these deficiencies were or will be corrected. <br /> IX. COMMENTS <br /> X. IN-TANK GAUGING TESTING <br /> I./I Check this box if tank gauqlnq is used only for inventory control. Do not complete this section. <br /> El Check this box if NO tank gauging equipment is Installed.(Do not complete this section.) Y N NA <br /> This section must be completed if in-tankgauging Is used to perform leak detection monitoring. <br /> Has all input wiring been inspected for kinks and breaks in the cables and for proper entry and termination,including testing for ground El El 13faults? <br /> Were all In-tank gauging probes visually inspected for damage and residue buildup to ensure that floats move freely,functionally tested, ❑ ❑ ❑ <br /> and confirmed o erational? <br /> Was accuracy of system's product level readings tested? ❑ ❑ ❑ <br /> Was accuracy of system's water level readings tested? ❑ ❑ ❑ <br /> Were all probes reinstalled property? ❑ ❑ ❑ <br /> Were all Items on the equipment manufacturer's maintenance checklist completed? ❑ ❑ <br /> For any answer of"N"above describe In section Xl how and when these deficiencies were or will be corrected. <br /> XI. COMMENTS <br />