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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 <br />Sensor Model <br />Component(s) Monitored <br />Pass <br />Fail <br />L1 <br />794380-301 <br />T1 Unleaded 87A Annular <br />® <br />❑ <br />L2 <br />794380-301 <br />T2 Unleaded 87B Annular <br />® <br />❑ <br />L3 <br />794380-301 <br />T3 Unleaded 91 Annular <br />® <br />❑ <br />L4 <br />794380-303 <br />T4 Additive Annular <br />® <br />❑ <br />L9 <br />794380-323 <br />Disp 1/2 UDC Sump Sensor <br />® <br />❑ <br />L10 <br />794380-323 <br />Disp 3/4 UDC Sump Sensor <br />® <br />❑ <br />L11 <br />794380-323 <br />Disp 5/6 UDC Sump Sensor <br />® <br />❑ <br />L12 <br />794380-323 <br />Disp 7/8 UDC Sump Sensor <br />® <br />❑ <br />L13 <br />794380-323 <br />Disp 9/10 UDC Sump Sensor <br />® <br />❑ <br />L14 <br />794380-323 <br />Disp 11/12 UDC Sump Sensor <br />® <br />❑ <br />L15 <br />794380-323 <br />Disp 13/14 UDC Sump Sensor <br />® <br />❑ <br />L16 <br />794380-323 <br />Disp 15/16 UDC Sump Sensor <br />® <br />❑ <br />L17 <br />794380-323 <br />Disp 17/18 UDC Sump Sensor <br />® <br />❑ <br />L18 <br />794380-323 <br />Disp 19/20 UDC Sump Sensor <br />® <br />❑ <br />L19 <br />794380-323 <br />Disp 21/22 UDC Sump Sensor <br />® <br />❑ <br />L20 <br />794380-323 <br />Disp 23/24 UDC Sump Sensor <br />® <br />❑ <br />L21 <br />794380-323 <br />T4 Additive Vent Sump <br />® <br />❑ <br />L22 <br />794380-304 <br />Disp 1/2 UDC Sump Brine Sensor <br />® <br />❑ <br />L23 <br />794380-304 <br />Disp 3/4 UDC Sump Brine Sensor <br />® <br />❑ <br />L24 <br />794380-304 <br />Disp 5/6 UDC Sump Brine Sensor <br />® <br />❑ <br />L25 <br />794380-304 <br />Disp 7/8 UDC Sump Brine Sensor <br />® <br />❑ <br />L26 <br />794380-304 <br />Disp 9/10 UDC Sump Brine Sensor <br />® <br />❑ <br />L27 <br />794380-304 <br />Disp 11/12 UDC Sump Brine Sensor <br />® <br />❑ <br />L28 <br />794380-304 <br />Disp 13/14 UDC Sump Brine Sensor <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 />