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UNDERGROUND STORAGE TANK MONITORING SYSTEM CERTIFICATION FORM VIII . MONITORING SYSTEM AND PROGRAMMING This section must be completed if a monitoring panel is used to perform leak detection monitoring. Y N N/A Are the visual and audible alarms operational ? ® ❑ ❑ Were all sensors visually inspected for kinks and breaks in the cables and for residual buildup to ensure that floats ® ❑ ❑ move freely, functionality tested, and confirmed operational? Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not ® ❑ ❑ interfere with their proper operation ? Was monitoring system set-up reviewed to ensure proper settings ? ® ❑ ❑ Was the monitoring panel's backup battery visually inspected, functionality tested, and confirmed operational? ® ❑ ❑ Does the flow if fuel stop at the dispenser if a leak is detected in the under-dispenser containment? ❑ ❑ Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operate or ® ❑ ❑ is electrically disconnected ? Does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak? ® ❑ ❑ Which sensors initiate positive shut down? (Check all that apply) ® sump ® Under- Dispenser Containment If alarms are relayed to a remote monitoring station, is all communications equipment ( e . g ., modem ) operational ? ❑ ❑ For any answer of "N" above, describe in Section IX how and when these deficiencies were or will be corrected. IX. COMMENTS i X . IN -TANK GAUGING TESTING ® Check this box if tank gauging is used only for inventory control . (Do not complete this section.) ❑ Check this box if NO tank gauging equipment is installed . (Do not complete this section) Y N N/A This section must be completed if in-tank gauging is used to perform leak detection monitoring. Has all input wiring been inspected for kinks and breaks in the cables and for proper entry and termination, ❑ ❑ ❑ including testing for ground faults? Were all in-tank gauging probes visually inspected for damage and residue build up to ensure that floats move ❑ ❑ ❑ freely, functionally tested, and confirmed operational ? Was accuracy of system' s product level readings tested ? ❑ ❑ ❑ Was accuracy of system's water level readings tested? ❑ ❑ ❑ Were all probes reinstalled properly? ❑ ❑ ❑ Were all items on the equipment manufacturer's maintenance checklist completed? ❑ ❑ ❑ For any answer of "N" above, describe in Section XI how and when these deficiencies were or will be corrected. XI . COMMENTS