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Underground Storage Tarek <br />Monitoring y tem 'ertification Form <br />6. MONITORING SYSTEM AND PROGRAMMING <br />A separate Monitoring System► certification Form rntist be prepared for each c®nor®I panel <br />Make of Monitoring System Model of Monitoring System Software Version Installed <br />Control Panel Control Panel <br />AvM <br />Attach the post -certification reports if the monitoring system is capable of generatingYes No NA <br />either, ❑Monitoring System Set-up Aiarm History Report <br />El <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❑ Elbuildup 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 p <br />secondary containment? <br />The monitoring system set-up was reviewed, and proper settings confirmed? 1"o 1 <br />Was the monitoring control panel's backup battery visually inspected, functionally ❑ p <br />tested, and confirmed operational? <br />Does the flow of fuel stop at the dispenser if a release is detected in the under- ❑ p <br />dispenser containment? <br />Does the turbine automatically shut down if the piping secondary containment ® ❑ <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 relea e? Which sensors initiate positive shut down? El <br />(Check all that apply) Sump UDC <br />If monitoring system alarms are relayed to a remote monitoring center, is all ® p <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 />