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Monitoring System Certificatio <br /> Site Address: �n �oLA-TLDate of Testing/Servicing: l/r1 l� <br /> D. Results of Testing/Servicing <br /> Software Version Installed: <br /> Complete the following checklist: <br /> Yes ❑ No* Is the audible alarm operational? <br /> Yes ❑ No* Is the visual alarm operational? <br /> es ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> 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 /> Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br /> ❑ NIA operational? <br /> Yes ❑ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br /> ❑ 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) *ump/Trench Sensors; ❑Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? .Yes; ❑No. <br /> ❑ Yes 4Vo* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br /> N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br /> fill point(s)and operating properly? If so,at what percent of tank capacity does the alarm trigger? % <br /> ❑ Yes* YNO, 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* No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> ❑Product; ❑Water. If yes,describe causes in Section E,below. <br /> Rf—y—es— <br /> o* Was monitoring system set-up reviewed to ensure proper settings? <br /> es o* 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 /> CALM-01 Page 2 of 3 11/15/99 <br />