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Y = Yes, N = No, NA Not <br />UNDERGROUND STORAGE TANK <br />MONITORING SYSTEM CERTIFICATION FORM (Page 4 of 6) <br />VIII. 'i MONITORING SYSTEM AND PROGRAMMING <br />This section must be completed if a monitoring panel is used to perform leak detection monitoring. <br />Y <br />N <br />NA <br />Are the visual and audible alarms operational? <br />rV <br />r <br />r <br />Were all sensors visually inspected for kinks and breaks in the cables and for residual buildup to ensure that floats <br />move freely, functionally tested, and confirmed operational? <br />IV <br />r <br />r <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not <br />interfere with their proper operation? <br />r <br />r <br />Was monitoring system set-up reviewed to ensure proper settings? <br />Io <br />r <br />r <br />Was the monitoring panel's backup battery visually inspected, functionally tested, and confirmed operational? <br />I✓ <br />r <br />Does the flow of fuel stop at the dispenser if a leak is detected in the under -dispenser containment? <br />I/ <br />r <br />r <br />Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operate or isr- <br />electrically 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.) 17Y, Sump r Under -dispenser containment <br />We <br />r <br />r <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? <br />IV <br />r <br />r <br />For any answer of "N" above, describe in section IX how and when these deficiencies were or will be corrected. <br />lXz COMMENTS <br />Use this section to provide any additional comments about the inventory of the equipment certified. <br />X IN -TANK GAUGING TESTING <br />r Check this box if tank gauging is used only for inventory control. (Do not complete this section.) <br />r Check this box if NO tank gauging equipment is installed. (Do not complete this section.) <br />This section must be completed if in -tank gauging is used to perform leak detection monitoring. <br />Y <br />N <br />NA <br />Has all input wiring been inspected for kinks and breaks in the cables and for proper entry and termination, including <br />testing for ground faults? <br />r <br />r <br />Were all in -tank gauging probes visually inspected for damage and residue buildup to ensure that floats move freely,r <br />functional) tested, and confirmed operational? <br />r <br />r <br />Was accuracy of system's product level readings tested? <br />iw <br />f <br />r` <br />Was accuracy of system's water level readings tested? <br />W <br />r <br />r <br />Were all probes reinstalled properly? <br />r <br />r <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />r <br />r <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 />Use this section to provide any additional comments about the inventory of the equipment certified. <br />Applicable <br />