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9255517888 Line 1 <br />UEtTLER-RYAN INC. <br />D, Results of Testing/Servicing <br />Software Version Installed: 333.05 <br />Complete the foilowina checklist: <br />4:25:13 09-25-2014 3/16 <br />GR Job # 10-0620 1 <br />CFI\JE <br />r <br />Yes <br />❑ o <br />Is the audible alarm operational? <br />tj Yes <br />(] No' <br />Is the visual alarm operational? IVI L.1 <br />E Yes <br />❑ No" <br />Were all sensors visually Inspected, functionally tested, and confirmed operational? <br />Ix Yes <br />® No' <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their <br />proper operation? <br />ff Yes <br />NN/A <br />If alarms are relayed to a remote monitoring station, is all communication equipment (e.g. modem) operational? <br />® <br />❑, Yes <br />❑ No' <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system <br />❑ WA <br />detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shutdown? (Check all that apply) <br />E Sump/Trench Sensor, E Dispenser Containment Sensor. Did you confirm positive shut -down due to leaks and sensor <br />i <br />failure/disconnection? Ej Yes; ❑ No. <br />[,t Yes <br />❑ No' <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no mechanical overfill prevention <br />❑ N/A <br />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 <br />of tank capacity does the alarm trigger? 90 <br />Yes <br />[] No <br />Was any monitoring equipment 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 />❑ Yes <br />No <br />Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) []Product; ❑ Water. If <br />yes, describe causes in Section E, below. <br />[j Yes <br />❑ No' <br />Was monitoring system set-up reviewed to Insure proper settings? Attach set-up reports, if applicable. <br />Yes <br />❑ No' <br />Is all monitoring equipment operational per manufacture's specifications? <br />,., v-. a ucww, uc—lua now anu wucn unse uenciencies were or wm oe eorrecrea. <br />E. Comments: <br />Replace all existing sensors 794380-323 to a 794380-208 during dispenser upgrade. <br />All new sensors were tested & pass - audibe , visual & positive shutdown. <br />Monitoring System Certification <br />Page 2 of 4 <br />2 <br />Received Time Sep.25, 2014 2.16PM No.7150 <br />12107 <br />