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D. Results of Testhag/Servicing <br /> Soffivare Version Installed: <br /> Complete the following checklist: <br /> ElrYes U No* Is the audible alarm operational? <br /> Ud Yes No* Is the visual alarm operational? <br /> Yes U No* Were all sensors visually inspected, functionally tested,and confirmed operational? <br /> 51'Yes U No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br /> not interfere with their proper operation? <br /> U Yes U No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br /> F61NIA operational? <br /> Yes U No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br /> U N/A monitoring system detects a leak, fails to oper5te, or is electrically disconpected? If yes:which sensors initiate <br /> positive shut-down? (Check all that apply) ff Sump/Trench Sensors; ff Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? Ur Yes; U No. <br /> U Yes L3 No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br /> B/N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br /> ALIA,F P 0 A2- , fill point(s)and operating properly? If so,at what percent of tank capacity does the alarm trigger? % <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 /> • Yes* (Er No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) Ll <br /> Product; U Water. If yes,describe causes in Section E,below. <br /> MrYes 0 No* Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports,if applicable <br /> rd—Yes 13 No* Is all monitoring equipment 2perational per manufacturer's specifications? <br /> *In Section E below,describe how and when these deficiencies were or will be corrected. <br /> E. Comments: <br /> Page 2 of 3 03/01 <br />