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RECEIVE <br /> D.Results of Testing/Servicing F�7 7 n 2014 <br /> Software Version Installed: 123.01 <br /> Complete the following checklist: ENVIRONMENTAL <br /> HFAj <br /> • Yes No* Is the audible alar operational? <br /> • Yes No* s the visual alar operational? <br /> • Yes No* Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> • Yes No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with <br /> heir proper operation? <br /> • Yes No* If alarms are 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 <br /> N/A ystem detects a leak,fails to operate,or is electrically disconnected?If yes:which sensors initiate positive shut-down?(Check <br /> all that apply)P Sump/Trench Sensors; P Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection?ro Yes; f No <br /> • Yes No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.no mechanical overfill <br /> N/A prevention valve is installed),is the overfill warning alarm visible and audible at the tank fill point(s)and operating properly?If <br /> at what percent of tank capacity does the alarm trigger?90% <br /> Yes* • No Nas any monitoring equipment replaced?If yes,identify specific sensors,probes,or other equipment replaced and list the <br /> anufacturer name and model for all replacement parts in Section E below. <br /> Yes* <br /> IT No as liquid found inside any secondary containment systems designed as dry systems?(Check all that apply) <br /> Product; r Water.[f es, <br /> s describe causes in Section E below. <br /> • Yes No* Nas monitoring system set-up reviewed to ensure proper settings?Attach set up reports,if applicable <br /> • Yes <br /> No- <br /> .s 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 3 12/07 <br />