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Underground Storage Tank DECEIVED <br /> Monitoring System Certification Form JAN 0 7 <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 /> L14 301 ANNULAR 0 ❑ <br /> L15 420 HI LIQUID ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> El El <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 DECEIVED <br /> JAN 0 7 2022 <br /> ENVIRONMENTAL <br /> HEALTH DEPARENT <br /> Page of 6 <br />