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i...RATARS Pilot/ Flying -7 - Lodi #617- Veee®` t #1 A :}� O SOUTHERN GOiO&NIA Daily Monitoring System Check Form 1 \ : V:) jm ❑ pm PrSiren OK ErAll bulbs light Ckfrinter works AFN* ❑ On-going alarm(s) 20,oam ❑ pmiren OK bulbs light 'rater works N* ❑ On-going aiarm(s) 3 - =1, Xam ❑ pm Z Siren OK [d loll bulbs light 0,Printer works O'XFN* ❑ On-going alarm(s) 4, r 1 am ❑ pm Siren OK It 7bulbs light rater works ❑ On-going alarm(s) 5 `• L,3 am ❑ pm iren OK II bulbs light .rinter works * ❑ On-going alarm(s) 6 ` `, OCV ❑ pm SireK Alt bulbs light rinter works N* 11 On-going alarm(s) 7 8°, am ❑ pm ❑ pm 1211ren OK Siren OKAll All bulbs light bulbs light Printer works Anter works N* N` ❑ On-going alarm(s) ❑ On-going alarm(s) 9 "% am ❑ pm Z'Siren OK All bulbs fight Printer works N* ❑ On-going alarm(s) 10 ❑ am El -if El-ften OK ❑,Wbulbs light ❑-Printer works i] On-going alarm(s) 11 am ❑ pm In'siren OK ®'All bulbs light R -Printer works - rAFN* -going alarms) 12 am ❑ pm en OK F.M bulbs light Winter works * ❑ On-going alarm(s) 13 `,til) ,gym ❑ pm 2fSiren OK til bulbs light laF'rinter works N* ❑ On-going alarm(s) 14 Ii/11"S „gram ❑ pm men OK ulbs light Winter works N* ❑ On-going alarm(s) 15 ''� . '�,” tram ❑ prr1,. tren OK C CII bulbs light DfVinnter works 01APN* ❑ On-going alarm(s) , bulbs light �nter works _C -AFN* ❑ On-going alarms) 317 " " °fit am ❑ pm Siren OK eAtIbulbs light IJ Printer works fU"AFN* ❑ On-going alarm(s) 18 -% ❑'am ❑ pm ffrSiren OK ©'All bulbs light 2 -Printer works jg AFN* ❑ On-going alarm(s) 19 7...5125ram p pm ETtken OK ..12(i bulbs light Mer works .fid-AFN* ❑ On-going alarm(s) 20 m ❑ pm C.Btren OK ,fid -All bulbs light ❑ P ' ter works 13,WN* ❑ On-going alarm(s) _ 21 l,j_Ua5rlb pm GY066n OK g,01-balt5slight [3,PMter works *- ❑ On-going alarm(s) 22 !CM &Srn P pm J218iren OK II bulbs light tenter works ❑ On-going alarm(s) 23 a %j JR m ❑ pm i; Wrren OK 1 t -bulbs light JZWdnter works ❑ On-going alarm(s) 24 "', is �Q [2 am ❑ pm 0 Siren OK Q'Ail bulbs light Wrinter works 'AFN* ❑ On-going alarm(s) 25 ❑ am ❑ pm 0 Siren OK ❑ All bulbs light ❑ Printer works ❑ AFN* ❑ On-going alarm(s) 26 ❑ am ❑ pm ❑ Siren OK ❑ Ail bulbs light ❑ Printer works 0 AFN* ❑ On-going alarm(s) 27 28 ❑ am D am ❑ pm ❑ pm ❑ Siren OK ❑ Siren OK ❑ AiI bulbs light ❑ All bulbs light Q Printer works ❑ Printer works ❑ AFN* ❑ AFN* ❑ On-going alarm(s) O On-going alarm(s) 29 ❑ am ❑ pm ❑ Siren OK ❑ All bulbs light ❑ Printer works ❑ AFN* O On-going alarm(s) 30 ❑ am ❑ pm ❑ Siren OK ❑ All bulbs light ❑ Printer works ❑ AFN* ❑ On-going alarm(s) 31 ❑ am ❑ pm ❑ Siren OK ❑ All bulbs light ❑ Printer works ❑ AFN* ❑ On-going alarms) * 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 "AFAr' box. If an alarm is occurring at the time of the daily MS test, check the "On-going Alarm(s)" box and record the sensor ID(s) and the alarm panel screen reading(s) under the Win Alarm, Screen Reads" column. Complete the separate UST System Alarm Response Lour 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.