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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM (Page 4 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? ® ❑ ❑ <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 operational? <br /> Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their ® ❑ ❑ <br /> proper operation? <br /> Was monitoring system set-up reviewed to ensure proper settings? ® ❑ ❑ <br /> Was the monitoring panel's backup battery visually inspected, functionally tested, and confirmed operational? ® ❑ ❑ <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 ® Under4spenser 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 /> 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 tank gauging equipment is installed. (Do not complete this section.) Y N NA <br /> This section must be completed ifln-tank gauging Is used to perfonn 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 ❑ ❑ ❑ <br /> faults? <br /> Were all In4ank gauging probes visually inspected for damage and residue buildup to ensure that floats move freely, functionally tested, ❑ ❑ ❑ <br /> 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? ❑ ❑ ❑ <br /> Foran answer of "N" above describe In section XI how and when these deficiencies were or will be corrected. <br /> XI. COMMENTS <br /> Y o Ypc N a Nn NA Nn} AnWirAMP <br />