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0onitoring System Certification 0 <br /> Site Address: 4747 WEST LANE Date of Testing/Service: 03/14/2002 <br /> D. Results of Testing/Servicing <br /> Software Version Installed: 16.04 <br /> Complete the following checklist: <br /> ® Yes ❑No• Is the audible alarm operational? <br /> ® Yes M No• Is the visual alarm operational? <br /> ® Yes ❑No• Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not <br /> ® Yes No• interfere with their proper operation? <br /> ® Yes E]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) ® Sump/Trench Sensors; ® Dispenser Containment Sensors. <br /> Did you confirm positive shutdown due to leaks and sensor failure/disconnection? ® Yes ❑ No <br /> ❑ Yes El No• ❑N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e-: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? % <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 M No• Was monitoring system set-up reviewed to ensure proper settings?Attach set-up reports,if applicable. <br /> ® Yes j E]No• Is all monitoring equipment operational per manufacturers'specifications? <br /> 'In Section E below,describe how and when these defciences were or will be corrected. <br /> E. Comments: <br /> page 2 of 3 <br />