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5. MONITORING SYSTEM AND PROGRAMMING <br />A separate Monitoring Sysfem Certification Form must be prepared for each control panel. <br />Make of Monitoring System <br />Control Panel <br />VEEDER ROOT <br />Model of Monitoring System <br />Control Panel <br />TLS 350 <br />Software Version I nstalled <br />329.00 <br />Attach the post-cerlification reports if the monitoring system is capable of generating <br />either; XMonitoring System Set-up X Alarm History Report Yes No NA <br />All monitoring equipment is operational per manufacturer's specifications?x n <br />Secondary containment systems are free of damage, debris, or liquid?X tr <br />Are the audible and visual alarms operational?X n <br />All sensors have been: 1)visually inspected forwiring kinks, breaks and residual <br />buildup on floats; and 2) tested for functionality and confirmed operational?X tr ! <br />Are all sensors installed to detect a release at the earliest opportunity in the <br />secondary containment?X T n <br />The monitoring system set-up was reviewed, and proper settings confirmed?x T f, <br />Was the monitoring control panel's backup battery visually inspected, functionally <br />tested, and confirmed operational?X n n <br />Does the flow of fuel stop at the dispenser if a release is detected in the under- <br />d ispenser containment?x n n <br />Does the turbine automatically shut down if the piping secondary containment <br />monitoring system fails to operate or is electrically disconnected?X n n <br />Does the turbine automatically shut down if the piping secondary containment <br />monitoring system detects a release? Which sensors initiate positive shut down? <br />Lc!99@lltlelgtpllAqs[p x uDC <br />X n f <br />lf monitoring system alarms are relayed to a remote monitoring center, is all <br />communication equipment operational?!n x <br />Underground Storage Tank <br />Monitoring System Certification Form <br />Describe all answers marked "No" or "Fail" and proposed remedy in Section g. <br />List all monitoring equipment either replaced or repaired in Section 9 <br />Page 2 of 6