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Dec 10 03 09:43a p.2 <br />D. Results of Testing/Servicing <br />"oftwa) e Version Installed: ) ;z LD / <br />Comph to the following checklist: <br />1, r"�;es_ ❑ No* Is the audible alarm operational? <br />fi )-Yes O No* Is the visual alarm operational? <br />G r-Y� ❑ No* Were all sensors visually inspected, functionally tested, and confirmed operational? <br />C I" Yes 13No* 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 />C sO No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br />�.-- ❑ NIA operational? <br />"Xes I ❑No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />C3 N/A monitoring system detects a leak, fails to operate, ��or.,.�* electrically disconnected? If yes: which sensors initiate <br />positive shut -down? (Check all that apply) W-Su-mptTrench Sensors; ❑ Dispenser Containment Sensors. <br />Did yon confirm positive shut -down due to leaks and sensor failure/disconnection? U-7'e's; ❑ No. <br />® Yes I ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (Le. no <br />❑"NTA 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* o 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* cmb 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 />f� Ves 0 No* Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable <br />Ca' >tes O No* Is all monitoring equipment operational per manufacturer's specifications? <br />* Ir Sectic n E below, describe how and when these deficiencies were or will be corrected. <br />E. Comments: <br />ti <br />Page 2 of 3 <br />03/01 <br />