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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 lD Sensor Model Component(s) Monitored Pass Fail <br /> L-1 VR 794380-208 REGULAR SUMP ✓❑ ❑ <br /> L-2 VR 794380-208 REGULAR AUX STP ✓❑ ❑ <br /> L-3 VR 794380-208 PREMIUM SUMP ❑✓ ❑ <br /> L-4 VR 794380-208 DIESEL SUMP ✓❑ ❑ <br /> L-5 VR 794380-301 REGULAR ANNULAR ✓❑ ❑ <br /> L-6 VR 794380-301 REGULAR AUX ANNULAR ❑✓ ❑ <br /> L-7 VR 794380-301 PREMIUM ANNULAR ✓❑ ❑ <br /> L-8 VR 794380-301 DIESEL ANNULAR ❑✓ ❑ <br /> L-9 VR 794380-208 REGULAR AUX FILL ❑✓ ❑ <br /> L-10 VR 794380-208 87 FILL SUMP ✓❑ ❑ <br /> L-11 VR 794380-208 91 FILL SUMP ❑✓ ❑ <br /> L-12 VR 794380-208 DIESEL FILL SUMP ❑✓ ❑ <br /> ❑ ❑ <br /> VR 847990-001 Dispenser 1 &2 Stand Alone ❑✓ ❑ <br /> VR 847990-001 Dispenser 3 &4 Stand Alone ❑✓ ❑ <br /> VR 847990-001 Dispenser 3 &4 Stand Alone ❑✓ ❑ <br /> VR 847990-001 Dispenser 7 &8 Stand Alone ❑✓ ❑ <br /> VR 847990-001 Dispenser 9 & 10 Stand Alone ✓❑ ❑ <br /> VR 847990-001 Dispenser 11 & 12 Stand Alone ❑✓ ❑ <br /> VR 847990-001 Dispenser 13 & 14 Stand Alone ❑✓ ❑ <br /> VR 847990-001 Dispenser 15 & 16 Stand Alone ❑✓ ❑ <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 3of6 <br />