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Monitoring System Certification <br /> Site Address 401 W. KETTLEMAN LN <br /> Date of Testing/Service: 11/05/2002 <br /> D. Results of Testing/Servicing <br /> Software Version Installed: 122.0 <br /> Complete the following checklist: <br /> ® Yes ❑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 /> ® Yes No• Were all sensors instal ed at lowest point of secondary containment and positioned so that other equipment will not <br /> interfere with their proper operation? <br /> LJ Yes No N/A If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem)operational? <br /> For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment <br /> ® Yes Ej No` N/A monitoring system detects a leak,fails to operate,or is electrically disconnected?If yes:which sensors initiate positive <br /> shut-down?(check all that apply) ® Sump/Trench Sensors; ❑ Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? <br /> Yes Ej No' ®N/A <br /> For tank systems that utilize the monitoring system as the primary tank overfill warninYes g device® o <br /> Le.:no mechanical <br /> overfill prevention valve'is installed),is the overfill warning alarm visible and audible at the tank fill points(s)and operating <br /> properly? If so,at what percent of tank capacity does the alarm trigg <br /> Yes` No Was any monitoring equipment er?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 /> FI Yes* ®No Was liquid found inside any secondarycontainment systems designed as dry systems?(check all that apply) ❑Product; <br /> ❑ Water. If yes,describe causes in Section E,below. <br /> ® Yes F1NoWas monitoring system set-up reviewed to ensure proper settings?Attach set-up reports, if applicable. <br /> ® Yes r]No• Is all monitoring equipment operational per manufacturers'specifications? <br /> ' In Section E below,describe how and when these deficiences were or will be corrected. <br /> E. Comments: <br /> page 2 of 3 <br />