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Underground Storage flank <br /> Monitoring System Certification Form <br /> S. MONITORING SYSTEM AND PROGRAMMING <br /> A separate Morrlforing System Certification Form must be prepared for each control panel. <br /> Make of Monitoring ystem Model of Monitoring System Software Version Installed <br /> Control Panel Control Panel <br /> Veeder-Foot TL 350 <br /> Aftach the post-certification reports if the monitoring system is capable of generating Yes No NA <br /> either; M Monitoring Systern Set-up fD Alarm History Report <br /> All monitoring equipment is operational per manufacturer's specifications? <br /> Secondary containment systems are free of damage. debris, or liquid? <br /> Are the audible and visual alarms operational? ® � <br /> All sensors have been: 9) visually inspected for wiring kinks, breaks and residual a El M <br /> buildup on floats; and ) tested for functionality and confirmed operational? <br /> Are all sensors installed to detect a release at the earliest opportunity In the 0 0 <br /> secondary containment? <br /> The monitoring system set-up was reviewed, and proper settings confirmed? i <br /> Was the monitoring control panel's backup battery visually inspected. functionally <br /> tested, and confirmed operational? <br /> Does the flow of fuel stop at the dispenser if a release is detected in the under- <br /> dispenser containment? <br /> Does the turbine automatically shut dawn if the piping secondary containment 0 <br /> monitoring system fails to operate or is electrically disconnected? Ell <br /> Does the turbine automatically strut dowry if the piping secondary containment <br /> monitoring system detects a release? Which sensors initiate positive shut down? <br /> _ heck all that apply) r] Sump rl UDC <br /> If monitoring system alarms are relayed to a remote monitoring center, is all <br /> communication equipment operational? <br /> Describe all answers marked "No"or'Fail'and proposed remedy in Secdon 9. <br /> List all monitoiing equipment either replaced or repaired in Section 9 <br /> Page 2 of 6 <br />