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ritutivtu <br /> OCT 2 2 2013 <br /> D. Results of Testing/Servicing ENVIRONMENTAL <br /> Software version Installed: HEALTH DEPARTMENT <br /> I <br /> hefollowin checklist: <br /> ❑ No' Is the audible alarm operational? <br /> ❑ No' Is the visual alarm operational? <br /> ❑ No' Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> ❑ No' Were all sensors installed at lowest point of secondary containment and poshioned so that other equipment will not interfere with their proper <br /> operation? <br /> ❑ No' If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.,modem)operational? <br /> N/A <br /> ❑ No' For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment monitonng systm detects a leak, <br /> N/A fails to operate, or is electrically disconnected? If yes:which sensors initiate positive shutdown? (Check all that apply) ❑ Sump/Trench <br /> Sensors; ❑Dispenser Containment SensorsDid you confine positive shut-down due to leaks and sensor failure/disconnection? ❑Yes; ❑No. <br /> ❑ No' For tank systems that utilize the monitoring system as the prmary tank overfill warning device li.e, no mechanical overfill prevention valve is <br /> N/A doesllthe,lathe overfill rigger?warning alarm visible and audible at the tank fill points)and operating property? If so,at what percent of tank capacity <br /> ® No Was any monitorng equipment replaced? If yes,identify specific sensors,probes,or other equipment replaced and list the manufacturer name <br /> and model for all replacement partsinSectionE,belo® 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' I Is all monitoring equipment operational per manufacturer's specrrfications? <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 />