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Wonitoring System Certification <br /> Site Address: 3 d Date of Testing/Servicing0-&"//�-I�Z-) <br /> D. Results of Testing/Servicing <br /> software Version Installed: / y <br /> plete the following checklist: <br /> ] es ❑ No* Is the audible alarm operational? <br /> es• ❑ No* Is the visual alarm operational? <br /> Y ❑ 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 /> ❑ N/A 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 opera or is electrically disconnected? If yes: hick sensois initiate <br /> positive shut-down?.(Check all that apply) Sump/Trench Sensors; ❑Dispenses Co inment Sensors. <br /> `Did you confirm positive shut-down due to leaks and sensor failure/disconnection? Yes; ❑No. <br /> Yes lA No* For tank systems that utilize the'monitoring.system as the prithary tank overfill warning device-(i.e. no <br /> (3..N/A. mechanical oyerfall prevention-valve is installed),is the overfill warning alarm visible and audible a tank <br /> fill points)and operrting properly?.If so,at what petcent of tank capacity does the alarm triggefl % <br /> ] Yes*'. No `Was any monitoring equipment replaced?.If yes,identify specific sensors,probes,or'other equipment replaced <br /> and list the mannficturar naniOnd model for all replacement parts in Section E,below. <br /> ] Yes* . a Wds liquid-found inside any secondary containment. designed as dry systems? (Check all that apply)' <br /> E3Product; .❑Water. If yes,describe causes in Section E,below. <br /> Y ❑ No*• Was monitoring system set-up eviewed.to ensure settings? <br /> es ❑ No* I Is all monitoring equipment operational per manufacturees specifications? , <br /> In.Section E below;desdribe how-and when these deficiencies were or will be corrected. <br /> E. Comments: <br /> CALM-01 Page 2.of 3 11115199- <br />