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i <br /> 2098253893 ENGINEERING DEPT. ring System Certification 09� :48 a.m. 09-10-2010 20/21 <br /> Mon <br /> Site Address 1777 W YOSEMITE AVE Date of Testing/Service: 08/13/2010 <br /> D. Results of Testing/Servicing <br /> Software Version Installed: NA <br /> i <br /> Complete the following checklist: <br /> x Yes No' Is the audible alarm operational? <br /> n Yes No" Is the visual alarm operational? <br /> ® Yes No' Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> Were all sensori installed at lowest point of secondary containment and positioned so that other equipment will not <br /> ❑x Yes ❑No° interfere with it proper operation? <br /> Yes No* x N/A If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem)operational? <br /> For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment <br /> Yes NoNIA monitoring system detects a leak,fails to operate,or is electrically disconnected?If yes:which sensors initiate positive <br /> shut-down?(check all that apply) ❑ Sump/Trench Sensors; ❑Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ❑Yes No <br /> ® ° ® For tank§ystems that utilize the monitoring system as the primary tank overfill warning device(i.e.:no mechanical <br /> Yes ®No N/A <br /> ovefill prevention valve is installed),is the overfill warning alarm visible and audible at the tank fill points(s)and operating <br /> properly? If so,at what percent of tank capacity does the alarm trigger? % <br /> Yes' n No Was ily monitoring equipment replaced?If yes,identify specific sensors,probes,or other equipment replaced and list the <br /> majitifecturer name and model for all replacement parts in Section E,below. <br /> ❑x Yes' ®No Was liquid found inside any secondary containment systems designed as dry systems?(check all that apply) ❑Product; <br /> ® Water. If yes,describe causes in Section E,below. <br /> ® Yes ®No• Was monitoring system set-?reviewed to ensure proper settings?Attach set-up reports,if applicable. <br /> Yes ®No° Is all monitoring equipmen'operational per manufacturers'specifications? <br /> "In Section E below,describe how and when these deficiences were or will be corrected. <br /> E. Comments: <br /> D APPROX.100ML OF WATER FROM PIPING SUMP.MONITORING UNIT HAS NO PRINTER.DAY TANK HAS 205 SENSOR INTHE <br /> i <br /> i <br /> I, <br /> Page 2 of 3 Based on CA form dated 03/08 <br />