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RECEIVED <br /> � n� :.. � _,. � �.:......itis <br /> SS21 0���r.R'g"P <br /> D, Results of Testing/Servicing J U I 17 2018 <br /> Software Version Installed: 133.06 <br /> Complete the followln9 checklist ENVIRONMENTAL <br /> wyes r-1 No' Is the audible alarm operational? HEALTH DEPAWKIEN <br /> Is the visual alarm operational? <br /> wyes No' <br /> d esNo' Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> WYes No' Were all sensors Installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their <br /> properoperation? <br /> L=" Nss <br /> No' If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem)operational? <br /> J N/A <br /> No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system <br /> �/ N/A Mects a leak,fails to operat r rs electrically disconnected? If yes:which sensors initiate positive shut-down? (Check a#that apply) <br /> L--Sump/Trench Sens es� ispenser Containnment Sermsors. Did you confirm positive shut-down due to leaks an sensor <br /> failure/disconnection? Peso. <br /> 8 No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.no mechanical overfill prevention ii <br /> N/A 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 /> of tank capacity does the alarm trigger? 90 % <br /> J No 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 arts in Section E below. <br /> I'. <br /> d No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) roduct; ater. If <br /> es describe causes in Section E,below. <br /> No" Was montoring system set-up reviewed to ensure proper settings?Attach set up reports,If applicable <br /> No* Is all monitoring equipment operational per manufacturer's specifications? <br /> *in Section E below,describe how and when these deficiencies were or will be corrected. <br /> E. Comments: <br /> Monitoring System Certification Page 2 of 4 12/07 <br />