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<br />Y = Yes, N = No, NA = Not Applicable <br />UNDERGROUND STORAGE TANK <br />MONITORING SYSTEM CERTIFICATION FORM (Page 4 of 6) <br />VIII. MONITORING SYSTEM AND PROGRAMMING <br />This section must be completed if a monitoring panel is used to perform leak detection monitoring. Y N NA <br />Are the visual and audible alarms operational? <br />Were all sensors visually inspected for kinks and breaks in the cables and for residual buildup to ensure that floats move freely, <br />functionally 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 their <br />proper operation? <br />Was monitoring system set-up reviewed to ensure proper settings? <br />Was the monitoring panel’s backup battery visually inspected, functionally tested, and confirmed operational? <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? <br />Which sensors initiate positive shut down? (Check all that apply.) Sump 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 /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <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 />Y N NA Check this box if NO tank gauging equipment is installed. (Do not complete this section.) <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 ground <br />faults? <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? <br />Was accuracy of system’s water level readings tested? <br />Were all probes reinstalled properly? <br />Were all items on the equipment manufacturer’s maintenance checklist completed? <br />For any answer of “N” above, describe in section XI how and when these deficiencies were or will be corrected. <br />XI. COMMENTS <br />Note: Site is equipped with remote overfill alarm on south wall of store. <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />