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UNDERGROUND STORAGE TANK MONITORING SYSTEM CERTIFICATION FORM (Page a of 6) VIII . MONITORING SYSTEM AND PROGRAMMING Y N NA Fsectionust be completed if a monitoring panel is used to perform leak detection monitoring. ❑ ❑ ❑ Are the visual 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 freely, FX1 ❑ ❑ functionally tested , and confirmed o erationai? p El El all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? 14 Was monitoring system set-up reviewed to ensure proper settings?9 Was the monitoring panel's backup battery visually inspected , functionally tested , and confirmed operational? X❑ ❑ ❑ Does the flow of fuel stop at the dispenser if a leak is detected in the under-dispenser containment? X❑ ❑ ❑ Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operate or is electrically FRI ❑ ❑ disconnected? Does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak? 0 ❑ ❑ Which sensors initiate positive shut down? (Check all that apply.) ❑X Sump ❑X Under-Dispenser Containment If alarms are relayed to a remote monitoring station, is all communications equipment (e .g . , modem) operational? X❑ ❑ I ❑ For any answer of "N" above, describe in Section IX how and when these deficiencies were or will be corrected. IX. COMMENTS X. IN-TANK GAUGING TESTING ❑X Check this box if tank gauging is used only for inventory control. (Do not complete this section.) y N NA ❑ Check this box if NO tank gauging equipment is installed . (Do not complete this section.) This section must be completed if in-tank gau Ing is used to perform leak detection monitorings i Has all input wiring been inspected for kinks and breaks in the cables and for proper entry and termination , including testing for F1 El ❑ round faults? Were all in-tank gauging probesvisually inspected for damage and residue buildup to ensure that floats move freely, functionally ❑ ❑ El tested , and confirmed operational? Q El Was accuracy of system's product level readings tested? ❑ Was accuracy of system's water level readings tested? ❑ ❑ ❑ Were all probes reinstalled properly? El 1:1 1:1 Were all items on the equipment manufacturer's maintenance checklist completed? F] El El how and when these deficiencies were or will be corrected. For any answer of "N" above, describe in Section XI X10 COMMENTS Y = Yes, N = No, NA = Not Applicable