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D. Results of Testing/Servicing <br />Software Version installed. <br />:omplete the followina checklist: <br />�rYJ/Yi,G1YUJU r -LL IV�f1 <br />.� 1d1N3WN0aUW:-] <br />LAI 6 1 adW <br />IE Yes <br />❑ No' <br />Is the audible alarm operational? <br />® Yes <br />❑ No' <br />Is the visual alarm operational? <br />® Yes <br />❑ No' <br />Were all sensors visually inspected, functionally tested, and confirmed operational? <br />® Yes <br />❑ No' <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper <br />operation? <br />❑ Yes <br />❑ No' <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) operational? <br />® N/A <br />® Yes <br />❑ No' <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak, <br />ClN/A <br />Fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut -down? (Check all that apply) ® Sump/Trench <br />Sensors, ❑ Dispenser Containment Sensors. <br />Did you confirm positive shut -down due to leaks and sensor failure/disconnection? ® Yes; ❑ No. <br />❑ Yes <br />❑ No' <br />For tank systems that utilize the monitoring system as the primary tank overtill warning device (i.e., no mechanical overfill prevention valve is <br />® N/A <br />installed), is the overfill warning alarm visible and audible at the tank fill points) and operating property? If so, at what percent of tank capacity <br />tleas the alarm trigger? 0 <br />❑ Yes <br />® No <br />Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name <br />and model for all replacement parts in Section E, below. <br />[]Yes* <br />® No <br />Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br />❑ Product; ❑ Waler. If yes, describe causes in Section E, below. <br />® Yes <br />❑ No' <br />Was monitoring system set-up reviewed to ensure proper settings?.Attach set up reports, if applicable <br />® Yes <br />❑ No' <br />Is all monitoring equipment operational per manufacturer's specifications? <br />In Section E below, describe how and when these deficiencies were or will be corrected. <br />E. Comments: SJC ON SITE ALL PASSED <br />Monitoring System Certification <br />Page 2 of 4 <br />2/21/07 <br />