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RECEIVED <br /> D.Results of Testing/Servicing JAS 2 9 2014 <br /> Software Version Installed: 330.00 ENVIRONMENTAL <br /> Complete the following checklist: HEAVTk DEPARTMENT <br /> o Yes r No* Is the audible alarm operational? <br /> 0 Yes r No* Is the visual alarm operational? <br /> * Yes r No* Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> * Yes r No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with <br /> heir proper operation? <br /> o Yes r No* If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem)operational? <br /> N/A <br /> *` Yes r No* For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment monitoring <br /> N/A stem detects a leak,fails to operate,or is electrically disconnected?If yes:which sensors initiate positive shut-down?(Check <br /> all that apply)W'Sump/Trench Sensors; WO Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection?0 Yes; r No <br /> • Yes r No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.no mechanical overfill <br /> prevention valve is installed),is the overfill warning alarm visible and audible at the tank fill point(s)and operating properly?If <br /> '+` N/A io,at what percent of tank capacity does the alarm trigger?% <br /> • Yes* * No Nas any monitoring equipment replaced?If yes,identify specific sensors,probes,or other equipment replaced and list the <br /> anufacturer name and model for all replacement parts in Section E below. <br /> Yes* o Nos liquid found inside any secondary containment systems designed as dry systems?(Check all that apply) <br /> ,1 Product• r Water.If yes,describe causes in Section E below. <br /> ra Yes No* as monitoring system set-up reviewed to ensure proper settings?Attach set up reports,if applicable <br /> Yes rNo* 11s 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 3 12/07 <br />