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UNDERGROUND STORAGE TANFC MONITORING SYSTEM CERTIFICATION FORM (Page a of s) � L VIII . MONITORING SYSTEM AND PROGRAMMING___ This section must be completed if a monitoring panel is used to perform leak defection monitoring. Y N NA 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, ® ❑ ❑ functionally tested , and confirmed operational? Were all sensors installed aflowest point of secondary containment and positioned so that other equipment will not interfere with Z ❑ ❑ their proper operation? Was monitoring system set-up reviewed to ensure proper settings ? ® ❑ ❑ Was the monitoring panel's backup battery visually inspected , functionally tested, and confirmed operational ? ® ❑ ❑ Does the flow of 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 Replaced TLS Battery for PM Purpose. i X. IWTANK 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 NA This section must be com leted if in-tank au in 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 ® ❑ ❑ round faults? Were all in-tank gauging probes visually inspected for damage and residue buildup 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 Xl how and when these deficiencies were or will be corrected. XI . COMMENTS Y = Yes, N = No, NA = Not Applicable