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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 5 , MONITORING SYSTEM AND PROGRAMMING <br /> A separate Monitoring System Certification Form must be prepared for each control panel. <br /> Make of Monitoring System Model of Monitoring System Software Version Installed <br /> Control Panel Control Panel <br /> Veeder Root TL&350R 3$6.01 <br /> Attach the post-certification reports if the monitoring system is capable of generating Yes No NA <br /> either; QMonitoring System Set-up 23 Alarm History Report <br /> All monitoring equipment is operational per manufacturers specifications? <br /> Secondary containment systems are free of damage , debris , or liquid? <br /> Are the audible and visual alarms operational ? <br /> All sensors have been : 1 ) visually inspected for wiring kinks , breaks and residual 0 <br /> buildup on floats ; and 2 ) tested for functionality and confirmed operational ? <br /> Are all sensors installed to detect a release at the earliest opportunity in the ® El <br /> secondary containment? <br /> The monitoring system set-up was reviewed , and proper settings confirmed ? 0 Li Ij <br /> Was the monitoring control panel 's backup battery visually inspected , functionally 0 D Ll <br /> tested , and confirmed operational? <br /> Does the flow of fuel stop at the dispenser if a release is detected in the under- R) L) El <br /> dispenser containment? <br /> Does the turbine automatically shut down if the piping secondary containment g <br /> monitoring system fails to operate or is electrically disconnected? <br /> Does the turbine automatically shut down if the piping secondary containment <br /> monitoring system detects a release? Which sensors initiate positive shut down ? L) Lj <br /> (Check all that apply ) Ll Sump J UDC <br /> If monitoring system alarms are relayed to a remote monitoring center, is all ® 9 <br /> communication equipment operational ? <br /> Describe all answers marked "No " or "Fail" and proposed remedy in Section 9. <br /> List all monitoring equipment either replaced or repaired in Section 9 <br /> Page 2 of 6 <br />