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Monitoring System Certification <br /> Site Ad Date of TestingfServicing: y <br /> D. Results of Testing/Servicing <br /> Software Version ed: <br /> COMMthe f cb . >,t: <br /> e ❑ No* Is the le alarm operational? <br /> s ❑ No* Is the vi alarm operational? <br /> Ya ❑ No* W all rs visually <br /> fncontested,and co operational? <br /> ❑ No* Were all sensors insWled at lowest point of secondary containment and positioned so that other equipment <br /> WHI not hwxfte with their EaM oMmon? <br /> Yes ❑ No* If alarm are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br /> ❑ N/A ?- <br /> Yes ❑ No* For pressurized pipes systems,does the turbine automatically shut down if the piping secondary con <br /> tainment <br /> ❑ N/A monitoring systern detects a leak, faits to operate, or is dally disconnected? if yes: which sensors <br /> initiate shut-down? (Check all that apply) Sump/Trench Sensors; ❑ Dispenser Containment <br /> Did you confirm positive shut-town due to leaks and sensor disconnection? 0 Yes; ❑No. <br /> kes ® No* Fortank syaems 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 proMly? If so at what Percent of tank does the alarm trigger? ?"/ <br /> ❑ Yes* o Was any monitoring equipment replaced? If yes, identify specific sensors <br /> probes, or other equipment <br /> and list the manufacturer name and model for all replacement Parts in Section E below. <br /> D Yes* No Was liquid inside any secondary containment systems designed as dry ? (Check all that apply) <br /> Q • ❑ Water. If yes,describe causes in Section E,below. <br /> es ❑ No* Was <br /> Yes to ? <br /> Is an irt <br /> oral per 's Vons? <br /> IR Section E below,describe how and when these deficiencies were or will be co <br /> E. Comments: <br />