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UNDERGROUND STORAGE TANK <br />MONITORING SYSTEM CERTIFICATION FORM (Page a of e) <br />VIII. MONITORING SYSTEM AND PROGRAMMING <br />This section must be completed if a monitoring panel is used to perform leak detection monitoring. <br />Y <br />N <br />NA <br />Are the visual and audible alarms operational? <br />N <br />❑ <br />Were all sensors visually inspected for kinks and breaks in the cables and for residual buildup to ensure that floats move freely, <br />tested, and confirmed operational? <br />m <br />1:1functional) <br />Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interferewith <br />proper operation? <br />� <br />❑ <br />El <br />Was monitoring system set-up reviewed to ensure proper settings? <br />® <br />❑ <br />❑ <br />Was the monitoring panel's backup battery visually inspected, functionally tested, antl confirmed operational? <br />® <br />❑ <br />Dces the flow of fuel stop at the dispenser if a leak is detected in the under -dispenser containment? <br />N <br />❑ <br />❑ <br />Does the turbine automatically shut down If the piping secondary containment monitoring system fails to operate or is electrically <br />disconnected? <br />❑ <br />❑ <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 N Under -Dispenser Containment <br />® <br />❑ <br />❑ <br />If alarms are relayed to a remote monitoring station, is all communications equipment (e.g.. modem) operational? <br />El ElFor <br />any answer of "N" above, describe in Section IX how and when these deficiencies were or will be corrected. <br />IX. COMMENTS <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,) <br />Y N <br />This section must be completed if in -tank gauging is used to perform leak detection monitoring, <br />NA <br />Has all input wiring been inspected for kinks and breaks in the cables and for proper entry and termination, including testing for <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 />El El ❑ <br />Was accuracy of system's product level readings tested? <br />Was accuracy of system's water level readings tested? <br />❑ ❑ <br />Were all probes reinstalled properly? <br />❑ ❑ ❑ <br />Were all items on the equipment manufacturers maintenance checklist completed? <br />❑ 1 ❑ ❑ <br />For any answer of "N" above, describe in Section XI how and when these deficiencies were or will be corrected. <br />XI. COMMENTS <br />Y = Yes, N = No, NA = NotAppkable <br />