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Jan , 23 . 2019 7148AM Donlee Pump Co No . 1366 P . 5 � .w UNDERGROUND STORAGE TANK MONITORING SYSTEM CERTIFICATION FORM (Pago 4 of 6) Y VIII . MONiTORING SYSTEM AND PROGRAMMING This section must be completed if a tnonitoring pinnal !s used to perlonn leak detection monitoring. Y N NA Are the visual and audible alarms operational? El '•Were all sensors visually inspected (or kinks and breaks in the cables and for residual buildup to ensure [fiat floats move freely, Nr ❑ ❑ °unctionall tested and confirmed operational? 'here all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their ❑ ❑ oro aro eration7 Illy Was monitoring system set-up reviewed to ensure proper settings? Was the monitoring panel's backup battery visually inspected, functionally tested, and confirmed operalional? 00 ❑ Does the flow of fuel stop at the dispenser if a leak Is detected in the under-dispenser containment? ❑ Does lime turbine automatically shut down if the piping secondary containment monitoring system falls to operate or Is electrically ❑ ❑ disconnected? I Does the turbine automatically shut down if the piping secondary containmeIM 5 El onitoring ystem detects a leak? ❑ Which sensors Initiate positive shut down? (Check ail that apply.) sump Under4spenser containment it auris are relayed to a remote monitoring station, Is all communications equipment (e .g• modem) operational? ❑ p ❑ For any answer of "N" above, describe In section IX how and when these deficiencies were or will he corrected, IX. COMMENTS AWN11101 600 4 , X. 1NJANK GAUGING TESTING IA Check this box if tank gauging is used only for inventory control, (Vo not complete IMS section.) Cl Check this box if NO lank gauging equipment is installed. (ao not complete thla section.) Y N NA chis section must be COMA . ietedltimtank au in is ased (o perform leak defection monitoring. Has ail input wiring been inspected for kinks and breaks in the cables and for proper entry and termination, Including testing for ground Ell ❑ 13 faults? Were all in-lank gauging probes visually Inspected for damage and residue buildup to ensure that floats move (reoty, functionally tested , p ❑ ❑ and confirmed operational? Was accuracy of system's product level readings tested? ❑ ❑ ❑ Was accuracy of system's water level readings tested? 0 Q ❑ Were all probes reinstalled properly? ❑ ❑ Were all items on the equipment manufacturer's maintenance checklist completed? ❑ p ❑ For any answer of 'IN" above describe in section Xi how and when these deficiencies were or will he corrected. XI . COMMENTS Hca • I V/ v � V.... KW kf . RIA SAW AnnlirnWe