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Monitoring System Certification <br /> A Results of Testing/Servicing <br /> Software Version Installed : 14. 04 <br /> Complete the following checklist : <br /> ® Yes ❑ No * Is the audible alarm operational? <br /> ® Yes ❑ No * Is the visual alarm operational? <br /> El Yes ❑ No * Were all sensors visually inspected, functionally tested, and confirmed operational? <br /> ® Yes ❑ No * Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br /> not interfere with their proper operation? <br /> ❑ Yes ❑ No * If alarms are relayed to a remote monitoring station, is all communications equipment (e . g . , modem) <br /> ® N/A operational? <br /> ® Yes ❑ No * For pressurized piping systems , does the turbine automatically shut down if the piping secondary containment <br /> ❑ N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes : which sensors initiate <br /> positive shut-down? (Check all that apply) ® Sump/Trench Sensors ; ® Dispenser Containment Sensors . <br /> Did you confirm positive shut- down due to leaks and sensor failure/disconnection? ® Yes; ❑ No . <br /> ❑ Yes ❑ No * For tank systems that utilize the monitoring system as the primary tank overfill warning device (i . e . , no <br /> ® N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br /> fill point( s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? % <br /> ❑ Yes * ® No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced <br /> and list the manufacturer name and model for all replacement parts in Section E, below. <br /> ❑ Yes * ® No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> ❑ Product; ❑ Water. If yes, describe causes in Section E, below. <br /> ® Yes ❑ No Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable <br /> ® Yes ❑ No * Is all monitoring equipment operational per manufacturer' s specifications? <br /> x In Section E below, describe how and when these deficiencies were or will be corrected. <br /> E . Comments : <br /> UN-036 — www. unidoes. org Rev. 01/17/08 <br />