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UNDERGROUND STORAGE TANK MONITORING SYSTEM CERTIFICATION FORM(Page 4 of s) VIII. MONITORING SYSTEM AND PROGRAMMING This section must be completed if a monitoring panel is used to perform leak detection monitoring. Y N NA Are the visual and audible alarms operational? N ❑ ❑ Were all sensors visually inspected for kinks and breaks in the cables and for residual buildup to ensure that floats move freely, N ❑ ❑ functionally tested,and confirmed operational? Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with ❑ ❑ their proper operation? Was monitoring system set-up reviewed to ensure proper settings? Q ❑ ❑ Was the monitoring panel's backup battery visually inspected,functionally tested,and confirmed operational? Q ❑ ❑ Does the flow of fuel stop at the dispenser if a leak is detected in the under-dispenser containment? Q ❑ ❑ Does the turbine automatically shut doom if the piping secondary containment monitoring system fails to operate or is electrically 1:1 1:1disconnected? Does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak? ❑ ❑ ❑ Which sensors initiate positive shut down? (Check all that apply.) 0 Sump ❑X under-Dispenser Containment If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.,modem)operational? Ll ❑ 0 For any answer of"N"above,describe in Section W how and when these deficiencies were or will be corrected. IX. COMMENTS X. IN-TANK GAUGING TESTING ❑X Check this box if tank gauging is used only for inventory control.(Do not complete this section) ❑Check this box if NO tank gauging equipment is installed.(Do not complete this section.) Y N NA This section must be completed if in-tank gauging is used to perform leak detection monitoring, Has all Input wiring been inspected for kinks and breaks in the cables and for proper entry and termination,including testing for ❑ ❑ ❑ round faults? Were all In-tank gauging probes visually inspected for damage and residue buildup to ensure that floats move freely,functionally E] F-1 1:1tested,and confirmed operational? Was accuracy of system's product level readings tested? ❑ ❑ ❑ Was accuracy of system's water level readings tested? ❑ ❑ ❑ Were all probes reinstalled properly? ❑ ❑ ❑ Were all items on the equipment manufacturer's maintenance checklist completed? ❑ ❑ ❑ For any answer of"N"above,describe in Section Xl how and when these deficiencies were or will be corrected XI. COMMENTS Y=Yes,N=No,NA=Not Applicable