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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM (Page ,3 of 6) <br /> Monitoring Device Used Device Model # Monitoring Device Used Device Model # <br /> Vent/Transition Sump ID : Vent/Transition Sump ID : <br /> Sump Sensor 1 Sump Sensor <br /> VPH Sensor r VPH Sensor <br /> UDC ID : 1 /2 UDC ID : <br /> r Electronic Sensor 794380-208 h Electronic Sensor <br /> • Mechanical Device r Mechanical Device <br /> • VPH Sensor F VPH Sensor <br /> UDC ID: 5/6 UDC ID : <br /> I✓ Electronic Sensor 794380-208 Electronic Sensor <br /> Mechanical Device Mechanical Device <br /> VPH Sensor r VPH Sensor <br /> i <br /> UDC ID : 3/4 ' UDC ID : <br /> I W Electronic Sensor 794380-208 Electronic Sensor <br /> s r Mechanical Device <br /> Mechanical Device <br /> VPH Sensor VPH Sensor <br /> UDC ID : 7/8 UDC ID: <br /> F Electronic Sensor 794380-208 Electronic Sensor <br /> r Mechanical Device I Mechanical Device <br /> VPH Sensor r VPH Sensor <br /> Other Monitored Component ID : Other Monitored Component ID : <br /> F Other(Specify in section VII) Other(Specify in section VII) <br /> Other Monitored Component ID : Other Monitored Component ID : <br /> rOther(Specify in section VII) Other(Specify in section VII) <br /> Other Monitored Component ID : Other Monitored Component ID : <br /> FOther(Specify in section VII) I I FOther(Specify in section VII) <br /> Include information for every underground storage tank component monitored by this monitoring system control panel. If the monitoring system <br /> control panel monitors more components than this form accommodates additoinal copies of these pages may be attached. <br /> VII . COMMENTS <br /> Use this section to provide any additional comments about the inventory of the equipment certified. <br /> CERS=California Environmental Reporting System , ID=Identification, UST=Underground storage tank, ICC=International Code Council <br />