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D. Results of TestinglSeruicing RECE'lVED,�IO V r}�f 0(� q <br /> 2 <br /> Software Version Installed: 121 A NOV 2017 <br /> Com iete the Ili n checklist: <br /> ® Yes ❑ No` Is the audible alarm operational? I r -'r <br /> ® Yes El No* Is the visual alarm operational? — <br /> IT <br /> H <br /> ® Yes ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? l <br /> ❑ Yes ❑ No* 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 ❑ No* 1f alarms a e relayed to a remote monitoring station,is all communications equipment(e.g.,modem)operational? <br /> ® N/A <br /> ® Yes ❑ No` For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak, <br /> ❑ N/A fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) ® Sump17rench <br /> Sensors; ®Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ®Yes; ❑No. <br /> ❑ Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(Le., no mechanical overfill prevention valve is <br /> ❑ N/A installed),is the overfill warning alarm visible and audible at the tank fill points)and operating properly? If so,at what percent of tank capacity <br /> does the alarm trigger? o/ <br /> ❑ Yes ❑ No 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' ❑ No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> ❑Product; ❑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 manufacturer's specifications? <br /> *In Section E below,describe how and when these deficiencies were or will be corrected. <br /> E. Comments: <br /> Monitoring System Certification Page 2 of 4 2+21/07 <br />