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Mo*ing System Certification 4b <br /> Site Address: 4943 S. KINGSLEY (FRONTAGE RD) Date of Testing/Service: 07/18/2003 <br /> HWY 99 @ ARCH AIRPORT RD <br /> Results of Testing/Servicing <br /> software version Installe¢19.05 <br /> Complete the following checklist: <br /> % Yes No Is the audible alarm operational? <br /> Q Yes No Is the visual alarm operational? <br /> Q Yes No Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> M Yes ❑No Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not <br /> interfere with their proper operation? <br /> El Yes No N/A If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem)operational? <br /> For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment <br /> © Yes No []N/A monitoring system detects a leak,fails to operate,or is electrically disconnected?If yes:which sensors initiate positive <br /> shut-down?(check all that apply) x❑ Sump/Trench Sensors; x❑ Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks ypd sensor failure/disconnection? ❑x Yes M No <br /> F1 Yes No X❑N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device(Le.:no mechanical <br /> overfill prevention valve is installed),is the overfill warning alarm visible and audible at the tank fill points(s)and operating <br /> property? If so,at what percent of tank capacity does the alarm trigger? a <br /> ❑ Yes ©No Was any monitoring equipment replaced?If yes,identify specific sensors,probes,or other equipment replaced and list the <br /> 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) ❑Product; <br /> ❑ 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 manufacturers'specifications? <br /> Lon E below, describe how and when these deficiences were or will be corrected. <br /> E. Comments: <br /> page 2 of 3 <br />