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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 6 . SENSOR TESTING RESULTS <br /> List only sensors tested on date of this certification . List "Sensor ID " as labeled in system <br /> programming. Additional copies of this page may be attached to accommodate all sensors tested. <br /> Sensor ID Sensor Model Component(s) Monitored Pass Fail <br /> Input# 1 LS -610 Annular Space ❑ <br /> Input#2 LS -600 Piping Sump ❑ <br /> Input#3 LS -600 piping Transition D ❑ <br /> Input#4 LS -600 Vent Transition 0 ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> E❑❑ El❑ El <br /> ❑ ❑ <br /> ❑ ❑ <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 3 of 6 <br />