COMPLIANCE INFO_2019 - Laserfiche WebLink

Home Browse Search

UNDERGROUND STORAGE TANK MONITORING SYSTEM CERTIFICATION FORM (Page a of s) Vill . MONITORING SYSTEM AND PROGRAMMING This section must be completed if a monitoring panel is used to perform leak detection monitoring. Ymm N NA Are the visual and audible alarms operational? © Q ❑ Were all sensors visually inspected for kinks and breaks in the cables and for residual buildup to ensure that floats move freely, © ❑ functional) tested , and confirmed operational? Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with ® EJtheir proper operation? El Was monitoring system set-up reviewed to ensure proper settings? 10 ❑ ❑ Was the monitoring panel's backup battery visually inspected, functionally tested , and confirmed operational? ❑ El Does the flow of fuel stop at the dispenser if a leak is detected in the under-dispenser containment? ❑ ❑ Z Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operate or is electrically disconnected? ❑ ❑ Z Does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak? El ❑ o Which sensors initiate positive shut down? (Check all that apply.) [l Sump ElUnder-DispenserContainment If alarms are relayed to a remote monitoring station, Wall communications equipment (e. g . , modem) operational? I ❑ El Q For any answer of "N" above, describe In Section IX how and when these deficiencies 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 clau 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 El EJ Eltested , and confirmed operational? Was accuracy of system's product level readings tested ? ❑ ❑ ❑ Was accuracy of system's water level readings tested? F ❑ El 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. XI. COMMENTS 8 ; > RM l YJN ENVIRONMENTAL HEALTH l`FP/ TSI NT Y = Yes, N = No, NA = Not Applicable i