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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM(Page a of 5) <br /> VIII. MONITORING SYSTEM AND PROGRAMMING <br /> This section must be completed if a monitoring panel is used to perform leak detection monitoring. Y I N NA <br /> Are the visual and audible alarms operational? 1�1 ❑ ❑ <br /> Were all sensors visually inspected for kinks and breaks in the cables and for residual bu Idup to ensure that floats move freely Q ❑ ❑ <br /> functional) tested,and confirmed operational? <br /> Were all sensors installed at lowest point of secondary containment and positioned so that other equipment volt not interfere with ❑ ❑ <br /> their proper operation? 19 <br /> Was monitoring system set-up reviewed to ensure proper settings? ❑X ❑ ❑ <br /> Was the monitoring panel's backup battery visually inspected,functionally tested,and confirmed operational? o ❑ ❑ <br /> Does the flow of fuel stop at the dispenser if a leak is detected in the under-dispenser containment? O ❑ ❑ <br /> Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operate or is electrically Q ❑ ❑ <br /> disconnected? <br /> Does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak? ❑ ❑ ❑ <br /> Which sensors initiate positive shut down? (Check all that apply.) 0 Sump 0 Under-Dispenser Containment <br /> If alarms are relayed to a remote monitoring station,is all communications equipment(e g modem)operational? 0 ❑ ❑ <br /> For any answer of"N"above,describe in Section IX how and when these deficiencies were or will be corrected. <br /> IX. COMMENTS <br /> X. IN-TANK GAUGING TESTING <br /> ❑Check this box if tank gauging is used only for inventory control.(Do not complete this section) <br /> ❑Check this box if NO lank gauging equipment is installed (Do not complete this section) Y N NA <br /> This section must be completed if in-tank gauging is used to perform leak detection monitoring. <br /> Has all input wiring been inspected for kinks and breaks in the cables and for proper entry and termination including testing for z F-1 ❑ <br /> round faults? _ <br /> Were all in-tank gauging probes visually inspected for damage and residue buildup to ensure that floats move freely functionally O El 11tested,and confirmed operational? <br /> Was accuracy of systems product level readings tested? ❑X I ❑ ❑ <br /> Was accuracy of system s water level readings tested? X ❑ ❑ <br /> Were all probes reinstalled properly' 0 1 ❑ ❑ <br /> Were all items on the equipment manufacturer's maintenance checklist completed? ❑X 1 01 ❑ <br /> For any answer of"N"above,describe in Section Xl how and when these deficiencies were or will be corrected. <br /> XI. COMMENTS <br /> Y=Yes.N=No,NA=Not Applicable <br />