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Monitoring System Certification-Page 2 of 3 Site Address: 2448 W. Kettleman Ln. Date of Testing/Servicing: 10125112 D. Results of Testing/Servicing Software Version Installed- 122.00 Complete the follo ing checklist: M Yes ❑ No* Is the audible alarm operational? ® Yes ❑ No* Is the visual alarm operational? ® Yes ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? M Yes ❑ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? ❑ Yes ❑ No* If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem) ® N/A operational? 0 Yes ❑ No* For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment ❑ N/A monitoring system detects a leak,fails to operate,or is electrically disconnected? If yes:which sensors initiate positive shut-down? (Check all that apply) ® Sump/Trench Sensors; ❑ Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ® Yes ❑ No ❑ Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.no ® N/A mechanical overfill prevention valve is installed),is the overfill warning alarm visible and audible at the tank fillpoint(s)and operating properly? If so,at what percent of tank capacity does the alarm trigger? 0 % ❑ Yes* ® No Was any monitoring equipment replaced?If yes,identify specific sensors,probes,or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E,below. ❑ Yes* ® No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) ❑ Product;❑ Water. If yes,describe causes in Section E,below. Cc Yes ❑ No* I Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports, if a licable. ® Yes I ❑ No* I Is all monitoring equipment operational per manufacturer's specifications? *In Section E below,describe how and when these deficiencies were or will be corrected. E. Comments: Monitor Certification performed for Permit Final due to replacement of 91 Turbine Relay.