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Monitoring System Certification <br /> Site Address: 2 Date of Testing/Servicing: <br /> D. Results of Testing(Servicing <br /> Software Version Installed: — rz-9z a6) <br /> Complete the foilowing checklist: <br /> Yes 0 No* Is the audible alarm operational? <br /> Yes 0 No* Is the visual alarm operational? <br /> Yes 0 No* Were all sensors visually inspected,functionally tested,and confimned operatioixal? <br /> ErYes 0 No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment] <br /> will not interfere with their pT <br /> Rer 2peration? <br /> 0 Yes 0 No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br /> 2"N/A operational? <br /> WYes 0 No* For press mued piping systems,does the an-bine aulomaucaUy shut down if the piping secondary containment <br /> 0 N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors <br /> initiate positive shut-down? (Check all that 4PP1Y) GPSumprrrench Sensors; Crtispenser Containment <br /> Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor fw1ureldisconnection? 'F-;I'Yes; 0 No <br /> • Yes 0 No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br /> B""N'/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br /> fill point(s)and 2pEpting properly? If so,at what percent of tank capacity does the alarm trigger? ??/r/a <br /> • Yes* El.-No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment <br /> replaced and list the manufacturer name and model for all replacement parts in Section IF,below. <br /> • Yes* Zr*No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that appkv) <br /> 0 Ptoduct` 0 Water Yyes,describe causes in Section E,below. <br /> es 0 No* Was monitoring system§eL-a reviewed to 2 <br /> es 1 0 No* I Is all!Ronit®riument 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 />