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MAR-23-2011 11:36 Service Station Systems 408 938 8888 P.04 <br /> Monitoring System Certification-Page 2 of 3 <br /> Site Address: 401 W. Kettleman Ln. Date of Testing/Servicing: 2123111 <br /> D, Results of Testing/Servicing <br /> Software Version Installed• 122.00 <br /> Com lete the folio Ing checklist: <br /> a Yes ❑ No* Is the audible alarm operational? <br /> Yes 0 No* Is the visual alarm o erational? <br /> 99 Yes p No* Were all sensors visually inspected, onally tested,and confirmed operational? <br /> a Yes ❑ 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 /> a Yes 0 Nos If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem) <br /> 17 N/A operational'? <br /> M Yes ❑ No* For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment <br /> 0 N/A monitoring system detects a leak,fails to operate,or is electrically disconnected? If yes:which sensors initiate <br /> positive shut-down? (Check all that apply) IN Su np/Trench Sensors; ❑ Dispenser Containment Sensors. <br /> Did Lou confirm positive shut-down due to leaks and sensor failure/disconnection? a Yes ❑ No <br /> a Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.no <br /> a N/A mechanical overfill prevention valve is installed),is the overfill warning alarm visible and audible at the tank <br /> fill points)and operating ro erl ? If so,at what percent of tank capacity does the alarm trigger? 0 % <br /> ❑ Yes* 11 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* a No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> Cl Product;❑ Water. If yes,describe causes in Section E,below. <br /> a Yes Cl Nos Was monitoring system set-u reviewed to ensure Rroper settings? Attach set-y2 Mort;, i 'a livable. <br /> IN 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 />