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AUG-24-2005 12:32 Service Station Systems 408 938 8888 P.04 <br /> Software Version Installed: <br /> Co lets the fo Rowing checklist: <br /> es I ❑ NO I Is the audible alarm operational? _ <br /> LLJ,es. © No* Is the visual alarm o erational? <br /> s D No* Were all sensors visually ins ected functiornali tested and confirmed op-.rational? <br /> Yes ❑ No* Were all sensors installed at luwcst point of secondary containment and positioned so that other cquipinent will <br /> not interfere with their proper operation? <br /> es ❑ No* if alarms are relayed to a remote monitoring station, is all comm nications equipment (e.g. modem) <br /> Q NIA operational? <br /> Ycs 0 No* For pressurized piping systems,does the turbine automatically shut dow i if the piping secondary containment <br /> D NIA monitoring system detects a kale,faits to oper56r is electrically discoi noctod? If yes:which sensors initiate <br /> positive shut-down? (Check all that appl)) -a Sumprrsench Sensors; D Dispenser CCo iinment Sensors. <br /> Did you confirm positive shut-down due to leaks and seu:.ui Pallwudise Getion? -ff Yes; D No. <br /> Yes C3�No* For tank systems that utilize the monitoring system as the primary ank overfill warning device (i,e, no <br /> �(N1A mechanical overfill prevention valve is installed),is the overfill warnin alarm visible and audible at the tank <br /> fill point(s) and operating properly? if so, at what percent of tar k. capacity docs the alami trigger? <br /> % <br /> 0 Yes* No Was any monitoring equipment replaced? If yes,identify specific sense probes,or other equipment replaced <br /> and Iist the manufacturer name and model far all replacement parts in Se tion E below. <br /> D Yes* 364o Was liquid found inside any secondary contairnment systems designed as dry systems? (Check all that apply) <br /> ❑'Product; D Water. if yes,describe causes in Section E,below. <br /> Yea/ D No* Was mon"' stem set-u reviewed to ensure proper settin s?Attac set up reports,if a licable <br /> es 0 No" I Is all monitoring a ui mento erational per manufacturer's s ecification ? <br /> W In Section E below,describe how and when these deficiencies were or will be corrected. <br /> E. Comments: —�^— <br /> Page 2 of 3 03101 <br /> I <br /> I <br />