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D. Results of Testing/Servicing <br /> Software Version Installed: 333.05 ISD 01-05 <br /> Complete the following checklist: <br /> C Yes ❑ No' Is the audible alarm operational? <br /> f] Yes ❑ No` Is the visual alarm operational? <br /> jr] Yes. ❑ No' Were all sensors visually inspected,functionally tested,and confirmed operational? <br /> Z Yes ❑ No` Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their <br /> proper operation? <br /> SJ Yes ❑ No' If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem)operational? <br /> ❑ N/A <br /> A7 Yes ❑ No` For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system <br /> ❑ N/A detects a leak,fails to operate,or is electrically disconnected? If yes:which sensors initiate positive shut-down? (Check all that apply) <br /> (OSump/Trench Sensors; ]Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor <br /> failure/disconnection? ®Yes; ONO. <br /> ❑ Yes ❑ No` For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e. no mechanical overfill prevention <br /> x❑ N/A valve is installed),is the overfill warning alarm visible and audible at the tank fill point(s)and operating properly? If so,at what percent <br /> of tank capacity does the alarm trigger? <br /> ki Yes' ❑ No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the <br /> manufacturer name and model for all replacement parts in Section E,below. <br /> ❑ Yes' )CI No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply)®Product; mWater. If <br /> es,describe causes in Section E,below. <br /> K❑ Yes ❑ No' Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports,if applicable <br /> U 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: <br /> L24 Tank 4 Fill sensor failed to alarm, replaced like for like, retested good. <br /> h� <br /> JUN 0 9 201 <br /> L I A A=Aa <br /> Monitoring System Certification Page of 12/07 <br />