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0 <br />Software Version installed: 3 Z� 1 _ <br />Com to <br />rhe tow'n <br />❑ No* <br />cnecK,ist: <br />Is the audible alarm operational? <br />Yes ° ' <br />CS Yes <br />❑ No* <br />Is the visual alarm operational? <br />In Yes <br />❑ No <br />Were all sensors visually inspected, functi nally tested, and confirmed o erational? <br />III Yes <br />❑ No* <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will <br />not interfere with their eroRer operation? <br />❑ Yes <br />❑ No* <br />If alarms are relayed to a remote monitoring station;. is all communications equipment (e.g. modem) <br />N/A <br />operational? <br />❑ No* <br />For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment <br />B Yes <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) ®. Sump/French Sensors; ® Dispenser Containment Sensors. <br />Did you confirm positive shut -down due to leaks and sensor failure/disconnection? LB Yes; ❑ No. <br />❑ Yes <br />❑ No* <br />For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no <br />N/A <br />mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank <br />fill point(s) and operating properly? If so, at what. percent of tank capacity does the alarm trigger? <br />GChPP <br />❑ Yes* <br />t� <br />® No <br />Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced <br />and list the manufacturer name and model for all replacement parts in Section E, below. <br />@S No <br />Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br />❑ Product; ❑ Water. If es, describe causes in Section E, below. <br />FOYes* <br />❑ No* <br />Was monitorin stem set -u reviewed to ensure ro r settin ? Attach set u re orts, if a licable❑ <br />No* <br />Is all monitorin Equipment 2erationa[ per manufacturer's specifications? <br />* Ire Section E below, describe how and when these deficiencies were or will be corrected. <br />E. Comments: <br />Page 2 of 3 03101 <br />