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ts of Testing/Servicing <br />.are Version Installed: /L' ; <br />.:o lets the following checklist: <br />Yes <br />❑ No* <br />Is the audible alarm operational? <br />Is the visual alarm operational? <br />Were all sensors visually inspected, functionally tested, and confirmed operational? <br />Yes <br />❑ No* <br />Qf-Yes <br />❑ No* <br />Yes <br />❑ No* <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment <br />will <br />not interfere with their proper operation? <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br />operational? <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />❑ Yes <br />❑ No* <br />RrN/A <br />Yes <br />❑ No* <br />❑ N/A <br />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) pp y) �ump/Trench Sensors; ❑Dispenser Co�ainment Sensors. <br />Did <br />❑ Yes <br />❑ No* <br />you confirm positive shut-down due to leaks and sensor failure/disconnection? tl�l'Yes; ❑ No. <br />For tank systems that utilize the monitoring system <br />C_N/A <br />as the primary tank overfill warning device (i.e. no <br />mechanical overfill prevention valve is installed), is the overfill warning alarm visible <br />❑ Yes* <br />No <br />and audible at the tank <br />fill oint(s) and o eratin ro erl ? If so, at what percent of tank capacity does the alarm tri er? <br />Was any monitoring equipment replaced? If <br />yes, identify specific sensors, probes, or other equipment replaced <br />and list the manufacturer name and model for <br />❑ Yes* <br />No <br />all replacement arts in Section E, below. <br />Was liquid found inside any secondary containment <br />systems designed as dry systems? (Check all that apply) ❑ <br />Product; ❑ Water. If es, describe causes in Section E, below. <br />es <br />Yes <br />❑ No* <br />❑ No* <br />Was monitoringsystem set-upreviewed to ensure proper settings? Attach set u re orts, if applicable <br />Is all monitorin2 <br />11 <br />a ui mentoperational per manufacturer's specifications? <br />* In Section <br />E below, <br />describe how and when these deficiencies were or will be corrected. <br />E. Comments: <br />Page 2 of 3 <br />03/01 <br />