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1�?onitoring System Certification <br />.Site Address:. // J ✓ %� `�� L <br />D. Results of Testing/Servicirig.' <br />Software Version Installed: f <br />—r <br />Complete the following checklist: <br />A- Date of Tcstia9PCrVicing_ // 2C <br />Yes <br />❑ No! <br />Is the audible alarm operational? <br />Yes • <br />❑ No' <br />Is the visual alarm operational? <br />❑ Yes <br />❑ No*. <br />Were all knsors visuallybspeced, functionally tested, and confumed opprationai? <br />❑ yes <br />❑ No* <br />Were, all seasons installed at lowest point of secondary containment and positioned so that other equipment will <br />not interfere with their proper operation? <br />❑ Yes <br />® No* <br />If alarms aro relayed to it reanote. monitoring statidn, is all communications equipment (c -g. modem)' <br />❑ N/A_ <br />operational? <br />L� _ Yes <br />❑ No* <br />]For pressauiaed piping systems, does the turbine automatically shut down if the piping secondary containment <br />. <br />❑ NIA . <br />monitoring system detects a leaf fans to operate,.or is elec trkally disconnected? If yes: which sensors initiate <br />positive shut -down? (Checkall that apply) ❑ Sumptrnendr SensoM ❑ Dispenser Containment Sensors. <br />- ' <br />'Did you canrum positive shut -down due: to leaks and sensor faUurdd=onnec ioa? ❑ Yes; -Cl No. <br />Q Yes <br />❑ No* <br />For -tank systems that utilrzo•thc monitoring system'as-the prituary tank'overfill weaning device (-i.e. -no <br />®. N/A <br />medranical'oveafli prevention•valve•is installed), is the overfill warning alarm visible and audible at the tank. <br />1-0 <br />.fill po s) and operating pMp&j1?.If so, art what:pareta of tank amity doesxhe mann trigged J. i' % <br />'Y&*: <br />❑ No- <br />:Was any monitoring equipment raplaocd? Ifyes, kkatify specific seauors, probes, onother equipment replaced- <br />- <br />- <br />and list the manufacturer name and model for all replacement parts in Section E, below.... .. - <br />❑ Yet* <br />N®. <br />Wasinaid,found insidemy scowHIMYsY - a4 my (Ujwk aUtha zp*) <br />❑ Product; ® Water- Myes, describe c Wscsin:Sedim A below. - - - <br />I:1,Yes <br />'❑ No* <br />Was systems set-up reviewed to cus=ptoprs settings? . t <br />Q Yes <br />®'N®* <br />b allm entopaational per a ris? . <br />* In Section E below; descry -be hoiw-and when these deficiencies were or will lie corrected. - <br />l'timmenfc- <br />