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UNDERGROUND STORAGE TANK MONITORING SYSTEM CERTIFICATION FORM (Page 4 of 6) VIII MONITORING SYSTEM AND PROGRAMMING This section must be completed if a monitoring panel is used to perform leak detection monitoring. Y7 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 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 under4spenser 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? ® El 13Which sensors initiate positive shut down? (Check all that apply.) ® Sump ® Under4spenser containment If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? 01 ❑ ❑ Foran answer of "N" above, describe in section W how and when these deSclencies were or will be corrected. IX. COMMENTS 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 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 ground El ❑ Elfaults? Were all in-tank gauging probes visually inspected for damage and residue buildup to ensure that floats move freely, functionally tested, El El ❑ and confirmed operational? Was accuracy of system's product level readings tested? ❑ ❑ ❑ Was accuracy of system's water level readings tested? 01 ❑ ❑ 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 X1 how and when these deficiencies were or will be corrected. X10 COMMENTS Y = Yes, N = No, NA = NotAppticcabie