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RECEIVED <br /> APR 10 2017 <br /> n a...=..e of r 5,2,sif/,cze:viiiisg <br /> Software Version Installed: 324.01 ENVIRONMENTAL HEALTH <br /> Com tete the following checklist: <br /> DEPARTMENT <br /> ® Yes No' Is the audible alarm operational? <br /> 0 Yes i No' Is the visual alarm operational? <br /> ® Yes 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 not interfere with their <br /> proper operation? <br /> n Yes - No' If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem)operational? <br /> ® N/A <br /> ® Yes No' For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system <br /> N/A detects a leak,fails to operate,or is electrically disconnected? If yes:which sensors initiate positive shut-down? (Check aU that ap-h. ) <br /> X Sump/Trench Sensors; ® Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor <br /> failure/disconnection? N Yes; - No. <br /> F Yes n No` For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e. no mechanical overfill prevention <br /> ® N/A valve is installed),is the overfill warning alarm visible and audible at the tank fill point(s)and operating properly? If so,at what percent <br /> of tank capacity does the alarm trigger? % <br /> Yes" M No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the <br /> manufacturer name and model for all replacement parts in Section E,below. <br /> Yes' ® No Was liquid found inside any secondary containment systems designed as dry system-0 (Check-all t`at apply) Prcdu �; Waier. If <br /> yes,describe causes in Section E,below. <br /> ® Yes No' Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports,if applicable <br /> ® Yes No" Is 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 /> TANK ANI'ULARS ARE 00-0!CAL SENc-ORS V/R 4 3s OPERATING AS DESIGNED. <br /> BOTH PREMIUM&DIESEL TANK FILLS HAVE OPW OVERFILL VALVES INSIDE DROP TUBES. <br /> Monitoring System Certification Page 2 of 4 12107 <br /> 2 2/21/07 <br />