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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM(Page 4 of 5 <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? a ❑ ❑ <br /> Were all sensors visually Inspected for kinks and breaks in the cables and for residual buildup to ensure that floats move freely, <br /> functionally tested,and confirmed o rallonal7 0 ❑ ❑ <br /> Were all sensors Installed at lowest point of secondary containment and positioned so that other equipment will not Interfere with <br /> their proper operation? ❑ ❑ <br /> Was monitoring system set-up reviewed to ensure proper settings? ❑X ❑ ❑ <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? ❑X ❑ ❑ <br /> Does the turbine automatically shut down if the piping secondary containment monitoring system faits to operate or Is electrically <br /> dlsconnected7 ❑X ❑ ❑ <br /> Does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak? ® ❑ ❑ <br /> Which sensors initiate positive shut down? (Cherk all that apply.) ❑X Sump X❑Under-Dispenser Containment <br /> If alarms are relayed to a remote monitoring station,Is an communications equipment(e.g.,modem)operational? 0 ❑ ❑ <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 /> No fuel in tanks to run turbines <br /> X. IN-TANK 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 lank 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 El ❑ <br /> round faults? <br /> Were all In-tank gauging probes visually Inspected for damage and residue buildup to ensure that floats move freely,functionally ❑X ❑ ❑ <br /> tested and confirmed operational? <br /> Was accuracy of system's product level readings tested? ❑X ❑ <br /> Was accuracy of system's water level readings tested? X ❑ ❑ <br /> Were all probes reinstalled properly? 0 I ❑ [] <br /> Were all Items on the equipment manufacturer's maintenance checklist completed? z I ❑ 0 <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 /> Y=Yes,N=No,NA=Not Applicable <br />