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t <br /> Monitoring System Certification <br /> •9S1 <br /> A Results of Testing/Servicing <br /> Software Version Installed: <br /> Complete the follo ing checklist: <br /> © Yes ❑ No* Is the audible alarm o erational? <br /> IRI Yes ❑ No* Is the visual alarm operational? <br /> D Yes ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> El Yes ❑ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br /> not interfere with their Eroper operation? <br /> ❑ Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br /> El N/A operational? <br /> ®Yes ❑ No* For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment <br /> ❑ N/A monitoring system detects a leak,fails to operate,or is electrically disconnected? If yes:which sensors initiate <br /> positive shut-down? (Check all that apply) ❑x Sump/Trench Sensors; ❑Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? 0 Yes; ❑No. <br /> ❑ Ye ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br /> I] N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br /> fillpoint(s)and o erating properly? If so,at what percent of tank capacity does the alarm trigger? _% <br /> ❑ Yes* 0 No Was any monitoring equipment replaced? If yes,identify specific sensors,probes,or other equipment replaced <br /> and list the manufacturer name and model for all replacement parts in Section E,below. <br /> ❑Yes* ❑x No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> ❑Product; ❑Water. If yes,describe causes in Section E,below. <br /> Exi Yes ❑ No* Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports,if applicable <br /> ❑x Yes ❑ No* Is all monitoring equipment oerational per manufacturer's specifications? <br /> *In Section E below,describe how and when these deficiencies were or will be corrected. <br /> E. Comments: *See Section H. <br /> UN-036-2/4 Page 2 of 4 Rev.06/04/01 <br /> www.unidoes.org <br />