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Monitoring System CertificationRECEIVED <br /> APR 112014 <br /> A Results of Testing/Servicing <br /> ENVIRONMENTAL HEALTH <br /> Software Version Installed: 333.05 DEPARTMENT <br /> Complete the fou Ing checklist: <br /> N Yes ❑ No* Is the audible alarm operational? <br /> N Yes ❑ No* Is the visual alarm operational? <br /> N Yes ❑ No* Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> N Yes ❑ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment <br /> will not interfere with their proper operation? <br /> N Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) <br /> ❑ N/A operational? <br /> N Yes ❑ No* For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment <br /> initiate positive shut-down? (Check all that apply) N Sump/Trench Sensors; N Dispenser Containment j <br /> Sensors. <br /> Did you confirm positive shut--down due to leaks and sensor failure/disconnection? N Yes; ❑No. <br /> ❑ Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e., no <br /> N N/A 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 /> ❑ Yes* N No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment <br /> replaced and list the manufacturer name and model for all replacement parts in Section E,below. <br /> ❑ Yes* N No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> ❑Product; ❑Water. If yes,describe causes in Section E,below. <br /> N Yes ❑ No* Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports,if applicable <br /> ® Yes ❑ 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: ONLY SENSOR TEST AFFECTED ITEMS FROM COLD START. i <br />