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011 3-09; 01 : 53PM;TOWN & COUNTRY CONTRACTORS ; 91 fi-63fi-9507 # 3/ 5 <br /> Monitoring System Certification <br /> s <br /> A Results of Testing/Servicing <br /> Software Version Installed: <br /> complete the following checklist: <br /> x Yes ❑ No* Is the audible alarm operational? <br /> x Yes ❑ No* Is the visual alarm operational? <br /> x Yes ❑ No* were all sensors visually inspected,functionally tested,and confirmed operational? <br /> x Yes ❑ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment <br /> will not interfere with their proper operation? <br /> x Yes [INo* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) <br /> i ❑ NIA operational? <br /> i <br /> x Yes ❑ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br /> ❑ NIA monilorino system detects a leak, fails to operate, or is electrically disconnected? If yos: -which sensors <br /> initiate positive shut-down? (Clieck all that apply) x Sump/Trench Sensors; [3 Dispenser Containment <br /> Sensors, <br /> Did you confirm positive shut-down due to leaks qjnd sensor failure/disconnection? x Yes; ❑No, <br /> x ales [] No* For tank systems that utilize the monitoring system as the primary tank over-ll warning device (i.e., no <br /> 4 ❑ 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? 90 % <br /> ❑ Ycs* x No was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment <br /> replaced and list the manufacturer name and model for all replacement parts in Section E,below. <br /> ❑ yes* x NO Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> ❑ Product; [3 Water. If yes, describe causes in Section E,below. <br /> x Yes C) No* Was monitoring system set-up revic%ved to ensure proper settings?Attach set up reports,if applicable <br /> x Yes ❑ No* Is all monitoring equipment operational per manufacturer`s specifications? <br /> * In Section E below,describe how and when these aleiiciencies were or will be corrected. <br /> E. Comments. <br /> l <br /> SII <br /> i <br /> i <br /> I <br /> Page 2 of 3 <br /> UN-436—2t4 <br /> MI"Muitaomorg Rev.OMCV06 <br />