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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM (Page a of 6) <br /> VIII . 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 ? © rEE11 <br /> ❑ <br /> Were all sensors visually inspected for kinks and breaks in the cables and for residual buildup to ensure that floats move freely , W1 El <br /> functional) tested , and confirmed o erational ? <br /> Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with ©their ra er o eration? <br /> Was monitoring system set-up reviewed to ensure proper settings? ElWas the monitoring panel's backup battery visually inspected , functionally tested , and confirmed operational? Z ❑ <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 ❑ ❑ <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 all that apply.) Sump ❑ Under-Dispenser Containment <br /> If alarms are relayed to a remote monitoring station, is all communications equipment (e . g . , modem) operational? [� ❑ ❑ <br /> For any answer of "N" above, describe in Section IX how and when these deficiencies were or will be corrected. <br /> IX. COMMENTS <br /> Replaced TLS Battery for PM Purpose. <br /> X. INJANK GAUGING TESTING <br /> ❑ Check this box if tank gauging is used only for inventory control. (Do not complete this section .) <br /> ❑ 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-tank gauging 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 © ❑ ❑ <br /> round faults? <br /> Were all in-tank gauging probes visually inspected for damage and residue buildup to ensure that floats move freely, functionally ❑ ❑ <br /> tested , and confirmed operational ? <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 properly? © ❑ ❑ <br /> Were all items on the equipment manufacturer's maintenance checklist completed? Z I ❑ I ❑ <br /> For any answer of "N " above, describe in Section Xi how and when these deficiencies were or will be corrected. <br /> XI . COMMENTS <br /> Y = Yes, N = No, NA = Not Applicable <br />