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Monitoring System Certification <br /> Site Address: <br /> Date of Tesbng/Servicwg: <br /> D. Results of Testing/Servicing <br /> Software Version Installed: <br /> —comlete the following checkliar <br /> es ❑ No* Is the audible alarm Operational? <br /> Yes p No* Is the visual alarm oust? <br /> xes p No* Were ail sensors visual *ctionall tested, and co <br /> nfumied Yes p No* Were all sensors installed at lowest point of secon rational? <br /> will not i re with thea uaY containment and positioned so that other equipment <br /> 0 Yes 13 a* If alarms are relayed to a flan? <br /> Q NIA �3 remote monitoring station, is all cvmmun cations equipment (e.g. modem) <br /> operational? <br /> ❑ Yes p ,Io* For pressurized piping systems, does the turbine automati <br /> �N/A monitoring system detects a leak, fails to 'eleshuctrically down if the piping ifM:secondary containment <br /> initiate positive shut-do�vn7 (Check all that a �� or is electrically discann�t�7 yam_ which seers <br /> Sensors. apply) ❑ SQmp/Irench Sensors; C3 Dispenser Containment <br /> Did you confirm positive shut-down due to leaks and sensor failureldmonnection7 ❑ Yes; o. <br /> 13/'Yes ❑ No* For tank systems that uiilizc the manitorin <br /> p NIA mechanical overfill g sY� as the primary tank overfill warning device (i.e. no <br /> fin prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br /> ' s and° ratin 1 7 If so,at what Percent of tank <br /> ❑ Yes* a Was any monitoring equipment capacity does the alarm tri 7 ?7??°/a <br /> lazed? If yes, identify specific sensors, probes, or other equips= <br /> Iaced and List the manufacturer name and model for all replacement in Section E, below. <br /> ❑ Yom* No Was liquid found inside any <br /> secondary containment systems designed as dry systems? (Check all them apply) <br /> ❑Product © Water. If desenbe causes in Section E, below. <br /> CS p No* Was monitorm stem set- reviewed to ensure <br /> EIMS <br /> Yes ❑ NO* Is all monitor•in rrrent o rational r man seum S7 <br /> " <br /> In Section E below,describe horn and when.these deficiencies were o ll,be corrected. s7 <br /> E. Comments: <br />