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1:t3! Rs Piot/FlyJ--Lodi#617- Veede?.-jot#1 •► urw•u Dai AST Monkdrig system Clhedc Foam Rev.08/14/2010 Date Tinne Daily Monitoring 1 ,.(dam ❑ pm 'ren OK All bulbs light C-14rinter works 7=,p1FN* ❑On-going ala (s) 2 f3.am ❑ pm 04iren OKeg' I bulbs light Printer works FN* ❑On-going ala' (s) 3 ❑ pm en OK ulbs light QJMnter works „p.AFN* ❑On-going alarm(s) 4 Elam �m n OK _PA bulbs light nter works D-AFN* ❑On-going alarm(s) 5 am ❑ prn 'ren OK 1 bulbs light ranter works ,AFN* ❑On-going alarm(s) 6 ❑am m Oziren OK f Wil bulbs light Printer works FN* ❑On-going alairm(s) 7 j ❑ pm 'ren OK WI1 bulbs light QPrinter works AFN* ❑On-going al 'rm(s) 8 m ❑pm siren OK IT-M bulbs light J94Drinter works AEN* ❑On-going alorm(s) 9 Elam OK bulbs light .J94erworks JAfN* ❑On-going alarms) 10 ❑am OK bu bs light works -going alelrm(s) 11 "� ❑am OK trlbs lightd1LworksAfN* ❑On-going aiarm(s) 12 ❑am J;Fetren OK ulbs light OlMnter worksN*__.❑On-going alarms) 13 'La-am ❑pm .0 Iren OK , Ail bulbs light -B'Rinter works N* ❑On-going alarm(s) 14 2-;am ❑pm ren OK 2'0-bulbs light4315r-inter works , N* ❑On-going alarm(s) 15 ® A Tam ❑pm ZMen OK All bulbs light ITNrtntef works ❑AFN* ❑On-going alarm(s) 16 ( 1 Z'am t❑pm .In* OK AJI bulbs light .-C Printer works ❑AFN* ❑On-going atarm(s) 17 E O ,®°gym ❑pm jtren OK [I-Ail bulbs light �BTrinter works ❑AFN* ❑On-going alarms) 18 ` dam D pm 'Siren OK aAI bulbs light PPrinter works p AFN* ❑On-going alarm(s) 19 Jb am ❑pm P,,girin OK P-All bulbs light J3-Printer works 0 AFN* ❑On-going alarm(s) 20 ❑pm Siren OK 12A bulbs light minter works 20W ❑On-going alarms) 21 ❑am wpmen OK bulbs light fl-r-Wer works AFN* ❑On-going alarms) 22 m ❑pm iren OK )21�A1t bulbs light Printer works AFN* ❑On-going alarm(s) 23 ❑am OK . albs light �xinter works ❑On-going alarm(s) 24 ❑am ❑pm ❑Siren OK ❑All bulbs light ❑Printer works ❑AFN* ❑On-going alarm(s) 25 ❑am ❑ pm ❑Siren OK ❑All bulbs light ❑Printer works ❑AFN* ❑On-going ajarm(s) 26 ❑am ❑pm ❑Siren OK 11 Al bulbs light ❑Printer works p AFN* ❑On-going alarm(s) 27 ❑ am ❑pm ❑Siren OK ❑Al bulbs light ❑Printer works ❑On-going alarm(s) 28 ❑ am ❑pm ❑Siren OK ❑All bulbs light ❑Printer works p AFN* ❑On-going olarm(s) 29 ❑am ❑pm ❑Siren OK O All bulbs light ❑Printer works ❑AFN* ❑On-going 'larm(s) 30 ❑am ❑pm ❑Siren OK ❑All bulbs light ❑Printer works ❑AFN* ❑On-going alarms) 31 ❑am ❑pm ❑Siren OK ❑All bulbs light ❑Printer works ❑AFN* ❑On-going Olarm(s) *AFN=ALL FUNCTIONS NORMAL(no current alarms) Instructions:Press the alarm test button on the UST monitoring systern(MS)and record the results under the"Daily Monitoring System Test Results column.If there are no current alarms, check the "AFN box.If an alarm is occurring at the time of the daily MS test,check the"On-going Alarnr(s)°box and record the sensor ID(s)and the alarm panel screen reading(s)under the"If In Alarm,Screen crate U T S Alarm Res n L 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 espon a fast column.