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9255517899 Line 1 01 -09 a.m. 04-01-2011 3/7 �GErrLEB-RYAN INC. GR Job # 10-058090 D. Results of Testing/Servicing Software Version Installed: 330.01 Complete the following checklist: r Yes ❑ 0. Is the audible alarm operational? rL Yes ❑ No" Is the visual alarm operational? [I Yes ❑ No' Were all sensors visually inspected,functionally tested,and confirmed operational? 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 communication equipment(e.g.modem)operational? E N/A Yes ❑ No' For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment monitoring system ❑ NIA detects a leak,faits to operate,or is electrically disconnected?If yes:which sensors initiate positive shut-down?(Check all that apply) E Sump[Trench Sensor; rX Dispenser Containment Sensor.Did you confirm positive shut-down due to leaks and sensor failure/disconnection? E Yes; ❑ No. Yes ❑ No' For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.no mechanical overfill prevention ❑ 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 of tank capacity does the alarm trigger? 90 % ry 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. �y Yes ❑ No' Was monitoring system set-up reviewed to insure proper settings?Attach set-up reports,if applicable. Yes [] No' Is all monitoring equipment operational per manufacture's specifications? In Section E below,describe how and when these deficiencies were or will be corrected. E. Comments: Monitoring System Certification Page 2 of 4 12107 2