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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 /> 1 L S - 3 DIESEL ANNULAR SPACE 0 ❑ <br /> 2 L S - 3 DIESEL S T P SUMP 121 ❑ <br /> 3 LS - 3 89 OCTANE S T P SUMP 0 ❑ <br /> 4 LS - 4 89 OCTANE S T P SUMP 0 ❑ <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 6 <br />