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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM (Page 4 of B) <br /> VIII, MONITORING SYSTEM AND PROGRAMMING <br /> This section must be completed if a monitoring panel is used to perform leak detection monitoring. Y N NA <br /> Are the visual and audible alarms operational? <br /> Were all sensors visually inspected for kinks and breaks in the cables and for residual buildup to ensure that floats move freely, ❑ ❑ <br /> functionally tested , and confirmed operational? <br /> Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not intertere with ❑ ❑ <br /> their proper operation? ❑ ❑ <br /> Was monitoring system set-up reviewed to ensure proper settings? <br /> Was the monitoring panel's backup battery visually inspected , functionally tested , and confirmed operational? [� El 11 <br /> Does the flow of fuel stop at the dispenser if a leak is detected in the under-dispenser containment? Q ❑ ❑ <br /> Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operI or is electrically Z ❑ ❑ <br /> disconnected? <br /> d <br /> Does the turbine autoah <br /> tically shut down if te piping secondary containmenm <br /> t onitoring sysm te <br /> melects a leak? © ❑ ❑ <br /> Which sensors initiate positive shut down? (Check all that apply.) W1 Sump ❑ Under-Dispenser Containment <br /> If alarms are relayed to a remote monitoring station , is all communications equipment (e.g . , modem) operational? 2 ❑ 1:1 <br /> For any answer of "N" above, describe in Section IX how and when these deficiencies were or will be corrected. <br /> IX. COMMENTS <br /> Replaced TLS Battery for PM Purpose . <br /> ID <br /> ��iC ts1� IL <br /> X. IN-TANK GAUGING TESTING <br /> ❑ Check this box if tank gauging is used only for inventory control. (Do not complete this section.) <br /> F1Check this box if NO tank gauging equipment is installed . (Do not complete this section.) Y N NA <br /> i This section must be completed if Inwitankgauging Is used to perform leak detection monitorin . <br /> Has all input wiring been inspected for kinks and breaks in the cables and for proper entry and termination , including testing for © ❑ ❑ <br /> round faults? <br /> j Were all in-tank gauging probes visually inspected for damage and residue buildup to ensure that floats move freely, functionally z ❑ ❑ <br /> tested , and confirmed o erational ? ❑ ❑ <br /> Was accuracy of system's product level readings tested? <br /> Was accuracy of system's water level readings tested ? © El EJ <br /> Were all probes reinstalled properly? © Li ❑ <br /> Were all items on the equipment manufacturer's maintenance checklist completed? 0 El 11 <br /> For any answer of "N" above, describe in Section X/ how and when these deficiencies were or will be corrected. <br /> XI . COMMENTS <br /> Y = Yes, N = No, NA = Not Applicable <br />