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Software Version Installed: ,123.02 <br />Isomplete [rre lull[Jm <br />H ulluum!lw6. <br />x Yes ❑ No' <br />Is the audible alar operational? <br />x Yes ❑ No' <br />Is the visual alar operational? <br />x Yes o No' <br />Were all sensors visually inspected, functionally tested, and confirmed operational? <br />x Yes ❑ No' <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their <br />proper o ration? <br />u Yes ❑ No" <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? <br />x N/A <br />❑ Yes ❑ No' <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system <br />U NIA <br />detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut -down? (Check all that apply) <br />❑ Sump/Trench Sensors; n Dispenser Containment Sensors. Did you confirm positive shut -down due to leaks and sensor <br />failure/disconnection? ❑ Yes; ❑ No. <br />x Yes r: No' <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no mechanical overfill prevention <br />❑ NIA <br />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 ca a ' does the alarm tri eO % <br />x Yes* n 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 />❑ Yes' x No <br />Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) ❑ Product; n Water. If <br />es, describe causes in Section E, below. <br />x Yes oi No" <br />Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable <br />x Yes ❑ No' <br />Is all monitoring equipment operational per manufacturer's specifications? <br />" In Section E below, describe now and when mese dencienwea were ur wul ue wl <br />E. Comments: —New Veeder Root TLS — 350, removed Incon TS -1000 and sensors <br />Monitoring System Certification Page 2 of 4 <br />12107 <br />2 2/21/07 <br />