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Monitoring Systeni Certification <br /> Site Address: Date of Testing/Servicing- <br /> D. Results of Testiag/Servicing <br /> Software Version Installed: <br /> Complete the folio ing checidist: <br /> IElfYes 0 No* Is the audible alarm operational? <br /> E�r)06 0 No* Is the visual alarm operational? <br /> 0 T Yes. 0 N& Were all sensorsvisuany inspected,EEaLo�mn test4 and confirmed operational? <br /> gWycs 0 No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment <br /> - will not interfere with their Lrgn 2peration? <br /> 0 Yes 0 Nd* if alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) <br /> Yes <br /> - [I'N/A operational? <br /> es 0 No* For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment <br /> 0 N/A monitoring system detects a leak, fails to operate, or IslefectricallY disconnecAed? Yes: which sensors <br /> initiate Positive shut-down? (Check all that apply) eSump/Trench Sensors-- �Dispenser Containment <br /> Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failurddISODrutection? OeY/es; 0 No. <br /> Yes 0 No* For tank systems that utilize the monitoring system as the Primary tank overfill warning device (i.e. no <br /> 0 N/A mechanical Overfill Prevention valve is installed), is the overfill warning abrin visible and audible at the tank <br /> fill point(s)and operating proverly? If so,at what Pe ment of tank capacity does the alarm trigger? ??.nlqr <br /> 0 Yes* Ll"NO Was any monitoring.._equipment replaced? If yes, identify specific sensors, probes, or other equipment <br /> re laced and list the manufacturer name and model for all re lacement pans in Section E,below. <br /> Yes* 0 No Was liquid found inside any secondary containment system designed as dry Systems? (Check all that apply) <br /> es <br /> 1 0 Product; Q Water. If Les,describe causes in Section E,below. <br /> es 4_ 0 No* I Was monitoring§ystem set-up reviewed to ensure ploper settings? <br /> Yes �Ny <br /> o* Ls alt monitoring 2quipmento 1xiational per manufacturer's cations? <br /> In Section E below,describe how and when these deficiencies were or will be corrected. <br /> E. Comments: ce. -47? VC --209 <br /> 62 A M Q J ea 0 <br />