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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. 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, 1:1 1:1functional) tested , and confirmed operational? 19 Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with a El El proper operation? Was monitoring system set-up reviewed to ensure proper settings? nX ❑ ❑ Was the monitoring panel's backup battery visually inspected, functionally tested, and confirmed operational? Q ❑ ❑ Does the flow of fuel stop at the dispenser if a leak is detected in the under-dispenser containment? ❑ ❑ 9 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 El sensors initiate positive shut down? (Check all that apply.) 0 Sump [:1 Under-Dispenser Containment If alarms are relayed to a remote monitoring station, is all communications equipment (e .g . , modem) operational? ❑ ❑ Q For any answer of "N" above, describe in Section IX how and when these deficiencies were or will be corrected. IX. COMMENTS X. INJANK ' GAUGING TESTING RI 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 round faults? N ❑ ❑ Were all in-tank gauging probes visually inspected for damage and residue buildup to ensure that floats move freely, functionally tested , and confirmed operational? 0 ❑ ❑ Was accuracy of system's product level readings tested? ❑ ❑ 0 Was accuracy of system's water level readings tested? ❑ ❑ Q Were all probes reinstalled properly? ❑ ❑ Were all items on the equipment manufacturer's maintenance checklist completed? []X ❑ ❑ 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