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Underground Storage Tank Monitoring System Certification Form 16. SENSOR TESTING RESULTS List only sensors tested on date of this certification. List "Sensor ID" as labeled in system programming. Additional copies of this page may be attached to accommodate all sensors tested. Sensor lD Sensor Model Component(s) Monitored Pass Fail L- 1 2 0 8 DISPENSER 1/ 2 0 ❑ L- 2 3 0 4 DISPENSER 1/ 2- BRINE 0 ❑ L- 3 2 0 8 DISPENSER 3/ 4 0 ❑ L- 4 3 0 4 DISPENSER 3/ 4- BRINE 0 ❑ L- 5 2 0 8 DISPENSER 5/ 6 0 ❑ L- 6 3 0 4 DISPENSER 5/ 6- BRINE 0 ❑ L- 7 2 0 8 DISPENSER 7/ 8 0 ❑ L- 8 3 0 4 DISPENSER 7/ 8- BRINE 0 0 L- 9 2 0 8 REGULAR UNLEADED S T P SUMP 0 ❑ L- 10 3 0 4 REGULAR UNLEADED S T P SUMP - BRINE RI ❑ L- 11 3 0 3 REGULAR UNLEADED ANNULAR SPACE 0 0 L - 12 3 0 4 REGULAR UNLEADED FILL SUMP - BRINE 0 ❑ L- 13 2 0 8 REGULAR UNLEADED FILL SUMP 0 ❑ L- 14 3 0 4 PREMIUM UNLEADED STP SUMP - BRINE 0 ❑ L- 15 2 0 8 PREMIUM UNLEADED FILL SUMP 0 ❑ L- 16 2 0 8 PREMIUM UNLEADED STP SUMP 0 ❑ L- 17 2 0 8 PREMIUM UNLEADED FILL SUMP - BRINE 0 ❑ L- 18 3 0 3 PREMIUM UNLEADED/ DIESEL ANNULAR SPACE ❑✓ ❑ L- 19 2 0 8 DIESEL STP SUMP 0 ❑ L- 20 3 0 4 DIESEL S T P SUMP - BRINE 0 ❑ L- 21 2 0 8 DIESEL FILL SUMP 0 ❑ L - 22 3 0 4 DIESEL FILL SUMP - BRINE 0 ❑ L- 23 2 0 8 VENT TRANSITION SUMP RI ❑ L-24 3 0 4 VENT TRANSITION SUMP - BRINE 0 LEI Describe all answers marked "No" or "Fail' and proposed remedy in Section 9. List all monitoring equipment either replaced or repaired in Section 9 Page 3 of 6