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Yes.

If there is oil visible on it or around it (it will get on a number of other things, including the alternator, and look like dirt) the shock is blown and the tensioner needs replacement. Its not hard, just fiddly as the clearance is tight.

There are marks on the tensioner and the hex that you use to release the tension so you can get the belt off. The belt is worn beyond service limits when the hex is outside the marks. You need a mirror to see it, but its clearly visible with one and a light.

The other possibility is that the roller on the tensioner, the alternator or A/C compressor bearings are either dead or locking up resulting in the belt squealing. They have to be pretty far gone to do that, so if that's what's going on you definitely want to take care of it. Note that the water pump has its own "stretchy" belt (no tensioner) and thus is not involved in this, but if you're changing one do both because you have to take the serpentine off to get the other one off, and you're definitely not doing that on the side of the road (the only reasonable way in to do it is through the wheel well, so that means removing the wheel and the splash shield.) It's not a tough job in your garage but on the side of the road will be no fun at all.
 

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There's no reason to replace the tensioner if it is not leaking and the roller's bearing is ok. I went close to 200,000 miles before I replaced mine.

I do the belts every 100k, and check the wear indicator every oil change (takes seconds with a mirror and flashlight.)
 
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