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_ D, -Results of Testing/Sewicing <br />Software Verslonlnstalied: Model LC1000 <br />ComolMa Mw m lnwlnn �Fnn Llleb <br />GR Job # 1720-4947 <br />S WRCB, January 2006 <br />❑ es <br />❑ o <br />Is the audible alarm operational? <br />❑ Yes <br />❑ No' <br />Is the visual alarm operational? <br />® 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 ration? <br />❑ 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 If the piping secondary containment monitoring system <br />❑ N/A <br />detects a leak, fails to operate, or is electrically disconnected? O yes: which sensors initiate positive shut -down? (Check all that apply) <br />❑ Sump/Trench Sensor, ❑ Dispenser Containment Sensor. Did you confine positive shut -dawn due to leaks and sensor <br />failure/disconnection? ff Yes; ❑ No. <br />❑ Yes <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 />® N/A <br />valve is installed), is the overfill warning alar visible and audible at the tank fill point(s) and operating property? If so, at what percent <br />of tank capacity does the alar bigger? % <br />❑ Yea <br />® No <br />Was any monitoring equipment replaced? If yes, Identify spec sensors, probes crother equipmentmplacedand list the <br />manufacturer name and modal for ell re abe ai arts m Section E, below. <br />❑ Yes <br />❑ No <br />Was IIquM found Inside any secondary conbinmanl systema tlesignod as dry systems? (Check all that apply) ❑pmducq ❑Water. O <br />as, describe causes in Section E, below. <br />13Yes <br />❑ No- <br />Was monitoring system set-up reviewed In insure proper settings? Attach set-up reports, O applicable. <br />Ves <br />❑ No' <br />Is all monitoring equipment oicermonai per manufacture's specificabons? <br />E. Comments: <br />Monitoring System Certification <br />were m con un comecrea. <br />Page 1 of 4 <br />2 <br />12/07 <br />