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Aug . 30 . 2019 8129AM Donlee Pump Co No . 2568 P . 5 UNDERGROUND STORAGE TANK i MONITORING SYSTEM CERTIFICATION FORM jPago a of 6) VIII, MONITORING SYSTEM AND PROGRAMMING This section must be completed 1f a monitoring panel is used to perform look defection moniforfag. Y N NA Are lhe 'visuai and audible alarms operational? ❑ ❑ Were all sensors visually inspected for kinks and breaks In the cables and for residual buildup to ensure that floats move ffeely, ❑ ❑ functionally tasted and confirmed operational? Were all sensors installed at lowest point of secondary containment and positioned So that other equipmentwill not interfere With their ❑ ❑ proper operation? Was monitoring system set-up reviewed to ensure proper settings? ❑ ❑ j Was the monitoring panel 's backup battery visually inspected, functionally tested, and confirmed operational? ❑ ❑ Does the flow of fuel stop at the dispenser if a leak is datecled in the under-dispenser canlainmall l? ❑ F1 Does the turbine automatically shut down if (fie piping secondary containment monitoring system fails to operate or is electrically Q ❑ disconnected? Does Iho4urbine automatically shut down if the piping secondary contain nt monitori system detects a leak? ❑ Which sensors initiate positive shutdown? ' (Check ell that apply.) Q1 Sump 13 Under-dispenser containment If alarms are relayed to a remote monitoring station, iS 211 communications equipment (e. g. modem) operational? © ❑ For any an5wor of "N" ahave, desorlb0 It, section IX how and when these doftlencles were or will he correcfed IX. COMMENTS X . iNJANK GAUGING TESTING Check this box if lank gauging is used only for inventory control. (Do not complelo this section.) ❑ Check this box if NO lank gauging equipment is Installed. (Do not complete this section.) Y N NA Tills section must be corn loted if in•tank agualho is used to erform leak detection monitorin g. Has all input wiring been inspected for kinks and breaks in the cables and for proper entry and termination, including testing for ground ❑ faults? Were all in4ank gauging probes visually Inspected for damage and residue buildup to ensure that floats move freely, functionally tested, p ❑ ❑ and confirmed operational? Was accuracy of system's product level readings tested? ❑ ❑ p Was accuracy of system's water loyal readings tested? ❑ Q Were all probes reinstalled properly? ❑ ❑ ❑ Were all items an the equipment manufacturer's maintenance checklist completed? ❑ ❑ ❑ For any answer of "N" above describe In section Xi how and when these deflelencles were or will be corrected, XL COMMENTS