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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM tPage a of s <br /> VIII . MONITORING SYSTEM AND PROGRAMMING <br /> Fsecdonmust be completed N a monitoring panel is used to perform leak detection monitoring. Y N NA <br /> Are the visual and audible alarms operational? Q 1 [� <br /> Were all sensors visually Inspected for kinks and breaks in the cables and for residual buildup to ensure that floats move freely, <br /> functionaliv tested and confirmed operational? <br /> Were all sensors Installed at lowest point of secondary containment and positioned so that other equipment will not interfere with 0 <br /> their proper operation? El 1:1 <br /> Was monitoring system set-up reviewed to ensure proper settings? N El El <br /> Was the monitoring panel's backup battery visually Inspected, functionally tested, and confirmed operational? Q 0 <br /> Does the flow of fuel stop at the dispenser if a leak is detected in the under-dispenser containment? <br /> Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operate or is electrically <br /> disconnected? <br /> Does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak? A <br /> El ElWhich sensors Initiate positive shut down? (Check all that apply.) 0 Sump ❑X Under=Dispenser Containment <br /> If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) operational? <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 /> Q Check this box if tank gauging is used only for Inventory control. (Do not complete this section.) <br /> ❑ Check this box If NO tank gauging equipment is installed. (Do not complete this section.) Y N NA <br /> This section must be completed if in-tank gauglng 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 <br /> round faults? El <br /> Were all in-tank gauging probes visually inspected for damage and residue buildup to ensure that floats move freely, functionally <br /> tested and confirmed operational? <br /> Was accuracy of system's product level readings tested? E] I [j I Fj <br /> Was accuracy of system's water level readings tested? El I El 1 0 <br /> Were all probes reinstalled property? El El I ET <br /> Were all items on the equipment manufacturer's maintenance checklist completed? El I El I El <br /> For any answer of "Al" above, describe in Section X1 how and when these deficiencies were or will be corrected. <br /> XI. COMMENTS <br /> Y = Yes, N = No, NA = NotAppOcabie <br /> ii <br /> i <br />