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MONITQRING SYSTEM CERTI ATION CERTIFICATION /TEST DATE: October 28. 2013 D. RESULTS OF TESTING / SERVICING Make / Model of Monitoring System: Veeder-Root TLS -350 Software Version Installed: 333.00 Complete the following checklist: ■ Yes ■ Yes ❑ No * Is the audible alarm operational? ❑ No • I� Ma audible alarm operational? ■ Yea ■ Yes ❑ No • Is the visual alarm operational? ❑ No * Is the visual alarm operational? ■ Yes ■ Yes ❑ No * Were all sensors visually inspected, functionally tested, and confirmed operational? ❑ No • Were all demon visually Inspected, functionally tested, eM coMimwtl operational? ■ Yes ■ Yes ❑ No * Were all sensors installed at lowest point of secondary containment and positioned so that other equipment ❑ No • Were all sensors installed K lowest point W secondary containment and positioned so NK other equipment will not Interfere with their proper operation? will not intertere with their proper operation? ❑ Yes ❑ Yes O No • ❑ No * If alarms are relayed to a remota monitoring station, Is all communications equipment (e.g. modems) If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modems) ■ WA ■ NIA operational? opentional9 For pressurized piping systems, does the turbine automatically a�u[ down H the piping secondary containment For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment ■ Yes ■ Yes ❑ No • ❑ No * ❑ N/A ❑ N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate monitoring system detects a leak, hits W operate, or is electrically disconnected? If yea: which sensor initiate positive shutdown? (check all that apply) � Sump/Trench sensors; 1 Dispenser Containment Sanson. positive shutdown? (check all that apply) ■ Sump/Trench sensors; ■Dispenser Containment Sensors. ■ Vq ■ Yes ❑ No * ❑ No' Did you confirm positive e��[Eown due W leaks gpQ senior Hiluro/Cbconnectloni Did you confirm positive shut -down due to leaks and sensor failure/disconnection? ❑ Yes ❑ Yes ❑ No' ❑ No * For lank systems NK utilize the monitoring system a the primary tank overfill warning device (i.e. no For tank systems that utilize the monitoring system as the primary tank overtill warning device (i.e. no ■ N/A ■ N/A mechanical overtill prevention valve is installed), is the overtill warning alarm visible and audible at the tank mechanical overfill prevention valve is installed), is Na overfill warning alarm visible and audible n Ma tank 1111 point(s) and operating property? If so, K what percent of tank capacity does the alarm trigger? fill points) and operating properly? If so, at what percent of tank capacity does the alarm trigger? _ ❑ Yes * ❑ Yes ■ No ■ No Wua�ry monitoring W��P�M�+WcoOi if yss. identify specific union, probes, or other equipment replaced 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. and IIH the manufacturer name entl model Mt all replacement garb In Section E, below. ❑ Yes * ❑ Yes ■ No ■ No Was any IlqulA found inside airy secondary eo�rtalnma�rt systems designed as dry systems? Was any liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) p Product; Q Water. If yes. describe causes In Section E, below. (Check all that apply) El ■ Yes ❑ No' Was monitoring system set-up m'lawatl to Insure P�>Mr settings? Attach set-up n0orts. H applicable. ■ Yes ❑ No' Is all monitoring equipment operational per manufacturer's specifications? IIn Section E below, describe how and when these deficiencies were or will be corrected. E. COMMENTS This is an MSC after cold start ❑Water. If yes, describe causes in Section E, below. ■ Yes ❑ No * Was monitoring system set-up reviewed to insure proper settings? Attach set-up reports, if applicable. ■ Yes ❑ No * _ Is all monitoring equipment operational per manufacturer's speclflcations? and replacement of ECPU2 board. Page 2 of 3