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Software Version Installed: <br /> Cginiplete the following checklist: <br /> Afflyes I ❑ No* Is the audible alarm operational? <br /> Yes ❑ No* Is the visual alarm operational? <br /> _Yes ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> ❑ YesNo* Were all sensors installed at lowest point of secondary containment and positioned so that oilier equipment w-*,'.. <br /> 101— not interfere with their proper operation? <br /> LJ Yes ❑ o* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br /> N/A operational? <br /> 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 oper ,or is electrically discon ed? If yes: which sensors initiate <br /> positive shut-down? (Check all that apply) Sump/Trench Sensors; Dispenser tainment Sensors. <br /> Did you confirm positive shut-down duet leaks and sensor failure/ isconnection? Yes; ❑No. <br /> ❑ Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br /> ❑ N/A 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 /> % <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 /> ,J Yes* ❑ No 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 /> Yes ❑ No* Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports, if applicable <br /> DI Yes ❑ No* Is all monitorin a ui mentoperational per manufacturer's s ecifications? <br /> * In Section E below,describe how and when these deficiencies were or will be corrected. / <br /> '. Comments: �/�A4/4�' SP/IfU/ e-,40 l <br /> AA d OA <br /> Page 2 of 3 03/01 <br />