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19 GFTTIER-RYAN INC. <br />D, Results of Testing/Servicing <br />Software Version Installed: NIA <br />Complete the following checklist: <br />AGR Job # 20-643211 <br />RECEIVED <br />JAN 13 2017 <br />r es <br />❑ o <br />Is the audible alarm operational? <br />US Yes <br />❑ No' <br />Is the visual alarm operational?_ i — <br />r, Yes <br />❑ No- <br />Were all sensors visually inspected, functionally tested. and confirmed operational? <br />Yes <br />❑ No' <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their <br />proper o erasion? <br />rL Yes <br />❑ No' <br />If alarms are relayed to a remote monitoring station, is all communication equipment (e.g. modem) operational? <br />❑ N/A <br />❑ Yes <br />❑ No' <br />For pressurized piping systems, does the turbine automatically shut down d the piping secondary containment monitoring system <br />ra N/A <br />detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut -down? (Check all that apply) <br />❑ Sump/Trench Sensor, ❑ Dispenser Containment Sensor. Did you confirm positive shut -doom due to leaks and sensor <br />failure/disconnection? ❑ Yes; ❑ No. <br />ry Yes <br />❑ No' <br />For lank systems that utilize the monitoring system as the primary lank overfill warning device (i.e. no mechanical overall Pmvenbon <br />❑ N/A <br />valve is installed), is the overfill warning alarm visible and audible at the tank fill points) and operating properly! If so, at what percent <br />of tank rapacity does the alarm trigger? % <br />❑ Yes <br />gy No <br />Was any monitonng 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 <br />a No <br />Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) ❑product; []Water If <br />yes, describe causes in Section E, below. <br />g Yes <br />❑ No' <br />Was monitoring system set-up reviewed to insure proper settings? Anach set-up reports, if applicable. <br />ry Yes <br />❑ No' <br />Is all monitoring equipment operational per manufacture's specifications? <br />' In Section E below, describe how and when these deficiencies were or will be corrected. <br />E. Comments: <br />Monitoring System Cemficatlon Page 2 of 4 12/07 <br />