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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 5 . ' MONITORING SYSTEM AND PROGRAMMING <br /> A separate Monitoring System Certification Fonn must be prepared for each control panel. <br /> Make of Monitoring System Model of Monitoring System Software Version Installed <br /> Control Panel Control Panel <br /> Veeder Root TLS - 350 330 . 01 <br /> Attach the post-certification reports if the monitoring system is capable of generating 11 <br /> either; © Monitoring System Set-up Alarm History Report Yes No : NA <br /> All monitoring equipment is operational per manufacturer's specifications ? <br /> Secondary containment systems are free of damage , debris , or liquid ? I l <br /> Are the audible and visual alarms operational? <br /> All sensors have been : 1 ) visually inspected for wiring kinks , breaks and residual <br /> buildup on floats , and 2 ) tested for functionality and confirmed operational ? <br /> Are all sensors installed to detect a release at the earliest opportunity in the M fn <br /> secondary containment? <br /> The monitoring system set-up was reviewed , and proper settings confirmed ? El El <br /> Was the monitoring control panel ' s backup battery visually inspected , functionally <br /> tested , and confirmed operational? <br /> III M .y <br /> Does the flow of fuel stop at the dispenser if a release is detected in the under In ri <br /> - <br /> dispenser containment? <br /> Does the turbine automatically shut down if the piping secondary containment <br /> monitoring system fails to operate or is electrically disconnected? <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 /> Check all that apply) Sump Ej UDC <br /> If monitoring system alarms are relayed to a remote monitoring center, is all In <br /> communication equipment operational ? <br /> Describe all answers marked "No " or "Fail it and proposed remedy in Section 9. <br /> List all monitoring equipment either replaced or repaired in Section 9 <br /> Page 2 of 6 <br />