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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 334.00 <br />Attach the post-certification reports if the monitoring system is capable of generating Neither;E Monitoring System Set-up Alarm History Report es 0 <br />All monitoring equipment is operational per manufacturer’s 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 r nbuilduponfloats;and 2)tested for functionality and confirmed operational? <br />Are all sensors installed to detect a release at the earliest opportunity in the rsecondarycontainment? <br />The monitoring system set-up was reviewed,and proper settings confirmed?EPI fl <br />Was the monitoring control panel’s backup battery visually inspected,functionally <br />tested,and confirmed operational? <br />Does the flow of fuel stop at the dispenser if a release is detected in the under- <br />dispenser containment? <br />Does the turbine automatically shut down if the piping secondary containment E fl flmonitoringsystemfailstooperateoriselectricallydisconnected? <br />Does the turbine automatically shut down if the piping secondary containment <br />monitoring system detects a release?Which sensors initiate positive shut down?ID ID <br />(Check all that apply)fl Sump UDC <br />If monitoring system alarms are relayed to a remote monitoring center,is all r rcommunicationequipmentoperational? <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 of6