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Monitoring System Certification-Page 2 of 3 Site Address: 3725 N.Tracy Blvd. Date of Testing/Servicing: 8127/12 D. Results of Testing/Servicing Software Version Installed• 127.04 Complete the following checklist: ® Yes ❑ No* Is the audible alarm operational? im Yes ❑ No* Is the visual alarm operational? to Yes ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? ® Yes ❑ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? cc Yes ❑ No* If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem) ❑ N/A operational? ❑ Yes ❑ No* For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment ® N/A monitoring system detects a leak,fails to operate,or is electrically disconnected? If yes:which sensors initiate positive shut-down? (Check all that apply) ❑ Sump/Trench Sensors; ❑ Dispenser Containment Sensors, Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ❑ Yes ❑ No ❑ Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.no H N/A mechanical overfill prevention valve is installed),is the overfill warning alarm visible and audible at the tank fillpoint(s)and operating ro erl ? If so,at what percent of tank capacity does the alarm trigger? 0 % ❑ Yes* ® No Was any monitoring equipment replaced?If yes,identify specific sensors,probes,or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E,below. ❑ Yes* N No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) ❑ Product;❑ Water. If yes,describe causes in Section E,below. ® Yes ❑ No* Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports,ff applicable. ® Yes 1 ❑ No* Is all monitoring equipment operational per manufacturer's specifications? *In Section E below,describe how and when these deficiencies were or will be corrected. E. Comments: Monitor Certification performed as Permit Final for replacement of 91 Annular&Fill Sump Sensors.