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Monitoring System Certification <br /> Site Address: ' a (f ► r )D/ 1'�t iii r ► _ ;f•.��..�`� — Date of•testing/Servicing: !7 <br /> D. Results of Testing/Servicing <br /> Software Version Installed: <br /> Complete the following checklist: <br /> Ye ❑ No* Is the audible alarm operational'? <br /> Yes ❑ No* Is the visual alarm operational'? <br /> Or'Te-s ❑ 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 <br /> not interfere with their proper operation? <br /> ❑ Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br /> ET—N/A operational? <br /> O Yes ❑ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br /> ❑ N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: -which sensors initiate <br /> positive shut-down? (Check all►her!apply) (�ip/ ispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? a-5es❑ No. <br /> ❑ Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br /> lq mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br /> fill point(s)and operating properly? If so, at what percent of tank capacity does the alarm trigger? % <br /> ❑ Yes* No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced <br /> and list the manufacturer name and model for all replacement parts in Section E, below. <br /> ❑ Yes* ffNo Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> ❑ Product; ❑ Water. If yes,describe causes in Section E,below. <br /> ❑ No* Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports, if applicable <br /> Wr�Yes ❑ No* I I'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 />