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� ��prARs Pilot/ Flying 1- Lodi #„617 Ve ..Root oot #2 0►SOUTNENMCAUMMIA Daily Monitoring ■ ■ 1 , l' am ❑ pm _Q -Si ren OK ►(bulbs light rinter works ❑ On-going alarm(s)l . 2 am ❑ pm Siren OK I bulbs light Printer works * ❑ On-going alarm(s) 3 �' am ❑ pmIren OK I bulbs light nnter works N* ❑ On-going alarm(s) 4 0aLm ❑ pm Xittiiren OK All bulbs light rinter works N* ❑ On-going alarm(s) 5 `�,q - Rfam ❑ pm 01 iren OK PAJI bulbs light printer works AFN* ❑ On-going alarm(s) 6 ; am ❑ pm R'Siren OK All bulbs light -.En'knter works N* ❑ On-going alarm(s) 7 ; m ❑ pm 01Siren OK it bulbs light A21 Printer works N* D On-going alarm(s) 8 am [I pm ja'Siren OK -E All bulbs light inter works 0N* ❑ On-going alarm(s) - 9r:” _ am D pm AdSiren OK Q%(I bulbs light ❑ nter works * D On-going alarm(s) 10 a . ❑ pm ire OK OK All bulbs light printer works N* ❑ On-going alarm(s) 11 a ❑ pm Iren OK y ulbs light Printer works ❑ On-going alarm(s) 12 j m ❑ pm Si >s OK All bulbs light rinter works 0`AFN* ❑ On-going alarm(s) 13 ' 1 am m W&ren OK All bulbs light Printer works - N* ❑ On-going alarm(s) 14 C am ❑ pm P-giren OK QAll bulbs light _J; -Printer works � D On-going alarm(s) ` 15 Z4_, 2 D pm _ iren OK 2 -All bulbs light 'Printer works FN* ❑ On-going alarm(s) 16 aq D pm ren OK II bulbs light _,.Z15rinter works * ❑ On-going alarm(s) 17 am ❑ pm'>9iren OK ulbs lightIn er works * , -going alarm(s) 18 Olam ❑ pm e0'Siren OK 'All bulbs light 21Pnnter works N* C7 On-going alarm(s) ' 19 tram . D pm iren OK R -All bAbs light minter works FN* ❑ On-going alarm(s) 20 t' }' m D pmptiren OK I bulbs light rinter works * ❑ On-going alarm(s) <(- 21 ;' lam ❑ pm -❑-Viren OK QAtrbulbs light ❑-Prifiterworks ZAN* ❑ On-going alarm(s) -* 22 , ` ❑ pm ..®Siren OK -Q4_1. bulbs light J�lPrinter works 43"AFN* ❑ On-going alarm(s) 23 ;tom;,} am ❑ pm 125lbiren OK All bulbs light -,,,R nnterworks AFN* ❑ On-going alarm(s) 24 r Q am ❑ pm P -Sir n OK I bulbs light _,,O-P-rinter works -O-kF-N* ❑ On-going alarm(s) 25 :t0 am ❑ pm Siren OKII bulbs light rl Per works 00W ❑ On-going alarm(s) 26 Wam ❑ pm Siren OK II bulbs light rinter works FWFN* D On-going alarm(s) 27 1 ' C t, ❑ am 0 -pm ESiren OK CSAII bulbs light 0 -Printer works D AFN* ❑ On-going alarm(s) # -. 28 � i✓�t m D pm wren OK D ulbs light -0-Printer works * ❑ Ort -going alarm(s) 29 C, 0-1 j2tm ❑ pm 12,Siren OK , '°All bulbs light ,,Printer works N* ❑ On-going alarm(s) 30 ;Oy am ❑ pm iren OK OAlIbulbslight Aafrinterworks rN* ❑ On-going alarm(s) 31 ' k am ❑ pm Iren OK 'bulbs light ,O--rinter works ❑ On-going alarm(s) ' AFN = ALL FUNCTIONS NORMAL (no, current alarms) Instructions: Press the alarm test button on the UST monitoring system (MS) and record the results under the "Daily Monitoring System Test Results" column. If there are no current alarms, check the "AW box. If an alarm is occurring at the time of the daily MS test, check the "On-going Alann(s)" box and record the sensor ID(s) and the alarm panel screen reading(s) under the "If in Alarm, Screen Reads:" column. Complete the separate UST System Alarm Response Lon for each MS environmental alarm noted (all alarms except "Paper Out" or "Fuel Delivery Needed"). Only a trained "Facility Employee" should complete this form or the Alarm Response Log. The FE should initial each entry made into this form using the last column.