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Mon•ring System Certification • <br /> Site Address: 4943 S. KINGSLEY (FRONTAGE RD) Date of TestingrService: 11/29/2001 <br /> HWY 99 @ ARCH AIRPORT RD <br /> Results of Testing/Servicing <br /> software Version Installed: <br /> complete the fallowing checklist: <br /> M Yes MNo Is the audible alarm operational? <br /> 0 YesF1No Is the visual alarm operational? <br /> El Yes No Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> El Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not <br /> Yes ❑No <br /> interfere with their proper operation? <br /> Yes M 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 0,�orate,or is electrically disconnected?If yes:which sensors initiate positive <br /> 1 <br /> shut-down?(check all that apply) I Sump/trench Sensors; ❑X Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and wnsor failure/disconnection? ❑X Yes F1 No <br /> Yes No 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 /> 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 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 /> ❑X 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 />