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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-2 LS -600 Fill Sump ❑� ❑ <br /> Input- 3 L & 600 Transition Sump ❑✓ ❑ <br /> Insput- 1 LS -610 Annular Space Z ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <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 16 <br />