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11 <br />Software Version Installed: 3_R_ - <br />y <br />NVIR4 tk'n BTA' <br />Com ptete Ute follow <br />g checklist: <br />Yes 0 No* <br />Is the audible alarm operational? <br />S Yes 0 No* <br />Is the visual alarm operational? <br />M Yes [I No* <br />Were all sensors visually Inspected, functionally tested, and confirmed operational?will not interfere with their <br />— secondary containment and positioned so that other equipment <br />-aflserisors <br />I@ yes TNe <br />Were installed at lowest point of <br />, <br />o Yes 0 No* <br />REEL2Eration? <br />if alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? <br />0 N/A <br />10 Yes El No* <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system <br />Initiate shut -down? (Check all that apply) <br />0 N/A <br />detects a leak, fans to operate, or is electrically disconnected? If yes: which sensors positive <br />S Sump/Trench Sensors; Ei Dispenser Containment Sensors. Did you confirm positive shut -down due to leaks and sensor <br />Yes 0 No* <br />failure/disconnection? 0 Yes; 0 No. mechanical overfill prevention] <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no me <br />0 <br />S 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 />I <br />0 Yes* 0 No <br />of tank capacity does the alarm trigger? % HAS MECHANICAL VALVE OVERFILL.) <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 />systems designed as dry systems? (Check all that apply) 0 Product; o Water. If <br />o Yes* 0 No <br />Y <br />Was livid found inside any secondary containment <br />Yes 0 No* <br />L'Nes <br />yes, describe causes in Section E, below. <br />Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable <br />0 No* <br />Is all monitoring equipment operational per manufacturers specifications? <br />* in Section E below, describe how and when these deficiencies were or will be co o. <br />NOTE: 1.) All three tanks have OPW overfill valves in drop tubes. <br />2.) Tested all UQC Bravo floats and chains in each dispenser. All tested good. (Total 10 floats and <br />chains.1 <br />Monitoring System Certification Page 2 of 4 <br />iELOb <br />2 2/21/07 <br />