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Site Address 1103 S. MAIN ST. <br />D. Results of Testing/Servicing <br />Software Version Installed: 328.03 <br />Complete the following checklist: <br />itoring System Certification <br />Date of Testing/Service: 02/03/2009 <br />X Yes <br />No * <br />Is the audible alarm operational? <br />❑X Yes <br />No' <br />Is the visual alarm operational? <br />0 Yes <br />EDNo * <br />Were all sensors visually inspected, functionally tested, and confirmed operational? <br />Yes <br />❑ No <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not <br />interfere with their proper operation? <br />FXJ Yes <br />No' <br />N/A <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? <br />Qx Yes <br />❑ No * <br />N/A <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />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) OX Sump/Trench Sensors; QX Dispenser Containment Sensors. <br />Did you confirm positive shut -down due to leaks and sensor failure/disconnection? ❑x Yes No <br />MX Yes <br />❑ No * <br />N/A <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e.: no mechanical <br />overfill 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? 90 % <br />Yes' <br />QX No <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 />QX Yes- <br />❑ No <br />Was liquid found inside any secondary containment systems designed as dry systems? (check all that apply) Xis Product; <br />P9 Water. If yes, describe causes in Section E, below. <br />QX Yes <br />No * <br />Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports, if applicable. <br />FX Yes <br />No * <br />Is all monitoring equipment operational per manufacturers' specifications? <br />* In Section E below, describe how and when these deficiences were or will be corrected. <br />E. Comments: <br />per inspector liquid in all fill sumps. unable to remove liquid due to unable to remove secon ary lids, plus sumps too deep to remove liquid. <br />Page 2 of 3 Based on CA form dated 03/01 <br />