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UNDERGROUND STORAGE TANK MONITORING SYSTEMA CERTIFICATION FORM (Page a of s) VIII. MONITORING SYSTEM AND PROGRAMMING This section must be completed if a monitoring panel Is used to perform leak detection 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 at lowest point of secondary containment and positioned so that other equipment will not interfere with ® ❑ ❑ their ro er 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? WJ ❑ ❑ Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operate or is electrically ❑ El ❑ 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 Wl above, describe in Section IX how and when these deficiencies were or will Abe IX. COMMENTS Replaced TLS Battery for PM Purpose . i I i I i i X. INJANK 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 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 91 ❑ ❑ 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? [71 ❑ ❑ 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? Q ❑ ❑ For any answer of "N " above, describe in Section XI how and when these deficiencies were or will be corrected, XI . COMMENTS Y = Yes, N = No, NA = Not Applicable