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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM <br /> VI11 . MONITORING SYSTEM AND PROGRAMMING <br /> This section must be completed if a monitoring panel is used to perform leak detection monitoring. Y N N/A <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 ® EJ 11 <br /> move freely, functionality tested, and confirmed operational? <br /> Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not ® El ❑ <br /> interfere with their proper operation? ® E:10 <br /> Was monitoring system set-up reviewed to ensure proper settings ? <br /> Was the monitoring panel' s backup battery visually inspected, functionality tested, and confirmed operational ? ® ❑ Li <br /> Does the flow if fuel stop at the dispenser if a leak is detected in the under-dispenser containment? ® El 1:1 <br /> Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operate or ® ❑ ❑ <br /> is 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) ® Sump ® Under- Dispenser <br /> Containment <br /> If alarms are relayed to a remote monitoring station, is all communications equipment ( e.g ., modem) operational? ® El El <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 N/A <br /> This section must be completed if in-tank gauging is used to perform leak detection monitoring. El El ElHas all input wiring been inspected for kinks and breaks in the cables and for proper entry and termination , <br /> including testing for ground faults ? <br /> Were all in-tank gauging probes visually inspected for damage and residue build up to ensure that floats move ❑ El El <br /> freely, functionally tested, and confirmed operational ? El 1:1 ❑ <br /> Was accuracy of system' s product level readings tested ? F1 El El <br /> Was accuracy of system' s water level readings tested ? ❑ ElEl <br /> all probes reinstalled properly? El LJ ❑ <br /> Were all items on the equipment manufacturer' s maintenance checklist completed ? <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 />