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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 I D" as labeled in system <br />programming <br />VPH site: ® Yes I ❑ No <br />Tank ID: 87 <br />Sensor ID <br />Sensor Model <br />Component(s) Monitored <br />Pass <br />Fail <br />L1 <br />208/304 <br />STP sump/brine <br />® <br />❑ <br />L2 <br />208/304 <br />fill sump/brine <br />® <br />❑ <br />S1 <br />463/464 <br />product <br />® <br />❑ <br />S2 <br />463/464 <br />vent <br />® <br />❑ <br />S3 <br />463/464 <br />annular <br />® <br />❑ <br />S4 <br />463/464 <br />vapor <br />® <br />❑ <br />9/9/2021 <br />❑ <br />❑ <br />S6 <br />463/464 <br />vent <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />Tank ID: 91 <br />Sensor ID <br />Sensor Model <br />Component(s) Monitored <br />Pass <br />Fal/ <br />L3 <br />208/304 <br />STP sump/brine <br />® <br />❑ <br />L4 <br />208/304 <br />fill sump/brine <br />® <br />❑ <br />S5 <br />463/464 <br />product <br />® <br />❑ <br />S6 <br />463/464 <br />vent <br />❑ <br />S10 <br />463/464 <br />91/DSL annular <br />® <br />❑ <br />❑ <br />❑ <br />9/9/2021 <br />❑ <br />❑ <br />S6 <br />463/464 <br />vent <br />® <br />❑ <br />❑ <br />❑ <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 9 <br />