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im GETTl ER -RYAN INC. <br />D. Results of Testing/Seivicing <br />Software Version Installed. NIA <br />Complete the following checklist: <br />GR Job # 20-643211 <br />[I <br />Yes <br />❑ <br />o <br />Is the audible alarm operational? <br />g <br />Yes <br />❑ <br />No' <br />Is the visual alarm operational? <br />E <br />Yes <br />❑ <br />No' <br />Were all sensors visually inspected, functionally tested, and confirmed operational? <br />rz <br />Yes <br />❑ <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 a rafion? <br />rL <br />Yes <br />❑ <br />No' <br />If alarms are relayed to a remote monitoring station, is all communication equipment (e.g. modem) operational? <br />❑ <br />NIA <br />❑ <br />Yes <br />❑ <br />No' <br />For pressurized piping systems, does the turbine automaticely shut down if the piping secondary containment monitoring system <br />ry <br />WA <br />detects a leak, fails to operate, or is electno diy disconnected? If yes: which sensors initiate positive shutdown? (Check all that appy) <br />❑ Sump/Trench Sensor; ❑ Dispenser Containment Sensor. Did you confine positive shut -down due to leaks 11114 sensor <br />failure/dieconnection? ❑ Yes; ❑ No. <br />E <br />Yes <br />❑ <br />No' <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e, no mechanical overfill prevention <br />❑ <br />N/A <br />valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly! N so, at what percent <br />of tank capacity does the alarm trigger? <br />❑ <br />Yes <br />ra <br />No <br />Was any monitoring 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 />❑ <br />Yes <br />ra <br />No <br />Was liquid found inside any secondary containment systems designed as dry systems? (Check all that appy) []Product; ❑Water. H <br />yes, describe causes in Section E, below. <br />U <br />Yes <br />❑ <br />No' <br />Was monitoring system set-up reviewed to insure proper settings? Attach set-up reports, H applicable. <br />Yes <br />❑ <br />No' <br />Is all mondonng equipment operational per manufacture's specifications? <br />In Section E below, describe how and when mese deficiencies were or will be connected. <br />E. Comments: <br />RECEIVED <br />Monitoring System Certification page 2 of 4 12/07 <br />DEC 2 6 2017 <br />ENVIRONMENTAL HEALTH <br />DEPARTMENT <br />