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JUL-04-2011 09:53 Service Station Systems 408 938 8888 P.09 <br /> Monitoring System Certification-.Page 2 of 3 <br /> Site Address: 2316 W. Grant Line Date of Testing/Servicing: 6110/11 <br /> D. Results of Testing/Servicing <br /> Software Version Installed <br /> Com lets the follo ing checklist: <br /> 3 Yes ❑ No* is the audible alarm operational? <br /> 8 Yes ❑ No* is the visual alarm operational? <br /> ® Yes ❑ No* Were all sensors visually inspected,functional) tested,and confirmed operational? <br /> X Yes ❑ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment'will <br /> not interfere with their Rroper operation? <br /> d Yes ❑ No* if alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem) <br /> 8 N/A operational? <br /> ❑ Yes ❑ No* For pressurized piping;systems,does the turbine automatically shut down if the piping secondary containment <br /> 2 N/A 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) C! Sump/Trench Sensors; ❑ Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? U Yes ❑ No <br /> ❑ Yes 0 No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.no <br /> ® N/A mechanical overfill prevention valve is installed),is the overfill warning alarm visible and audible at the tank <br /> fillpoint(s)and operating ro erly? if so,at what jEcent of tank capacity does the alarm trigger? 0 % <br /> n V&e* M Mn Wac nnv mnnitnrinn snuinment renlaced?if ves.identifv specific sensors,probes,or other equipment replaced <br /> and list the manufacturer name and model for all replacement garts in Section E,below. <br /> ❑ Yes* 0 No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> p Product;❑ Water. !fes, causes in Section E,below. <br /> a Yes 0 No* Was monitorinG! stem set-tip reviewed to ensure proper settings? AItach.sel-u reports. if geglicable.2 <br /> N Yes l3 No* is all monitoring equipment operational per manufacturer's specifications? <br /> in Section E below,describe how and when these deficiencies were or will be corrected. <br /> E. Comments: <br />