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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 /> L-1 409 87 ANNULAR 0 ❑ <br /> L-2 208 87 FILL 0 ❑ <br /> L-3 208 87 STP 0 ❑ <br /> L-4 409 91 ANNULAR F21 ❑ <br /> L-5 208 91 FILL 1z ❑ <br /> L-6 208 91 STP 0 ❑ <br /> 1 001 DISP 1-2 STAND ALONE z ❑ <br /> 2 001 DISP 3-4 STAND ALONE Z ❑ <br /> 3 001 DISP 5-6 STAND ALONE 0 ❑ <br /> 4 001 DISP 7-8 STAND ALONE 0 ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ o <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 />