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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, o ❑ <br /> functional) 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 ® ❑ ❑ <br /> their 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? Q ❑ ❑ <br /> Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operate or is electrically Eldisconnected ? <br /> El <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? El ❑ <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 /> Replaced TLS Battery PM Purpose , <br /> i <br /> i <br /> i <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 /> ❑ 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 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 ❑ EJ <br /> faults? <br /> 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? ❑ ❑ ❑ <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 Xl how and when these deficiencies were or will be corrected, <br /> XI. COMMENTS <br /> f <br /> Y = Yes, N No, NA = Not Applicable <br />