Laserfiche WebLink
Underground Storage Tank <br />Monitoring System Certification Form <br />[: z6*91:a9*1111,10N*'1110 <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 Component(s) Monitored <br />Pass <br />Fail <br />Ll <br />794380-208 <br />87 STP SUMP <br />® <br />0 <br />L2 <br />794380-304 <br />87 STP BRINE <br />® <br />0 <br />L3 <br />794380-208 <br />91 STP SUMP <br />® <br />0 <br />L4 <br />794380-304 <br />91 STP BRINE <br />® <br />0 <br />L5 <br />794380-208 <br />DIESEL STP SUMP <br />L6 <br />794380-304 <br />DIESEL STP BRINE <br />M <br />ri <br />L7 <br />794380-208 <br />87 FILL SUMP <br />® <br />0 <br />L8 <br />794380-304 <br />87 FILL BRINE <br />® <br />0 <br />L9 <br />794380-208 <br />91 FILL SUMP <br />M <br />0 <br />L10 <br />794380-304 <br />91 FILL BRINE <br />M <br />0 <br />L11 <br />794380-208 <br />DIESEL FILL SUMP <br />® <br />0 <br />L12 <br />794380-304 <br />DIESEL FILL BRINE <br />® <br />0 <br />L13 <br />793380-303 <br />87 ANNULAR <br />® <br />0 <br />L14 <br />793380-303 <br />91 -DIESEL ANNULAR <br />0 <br />L15 <br />794380-208 <br />VENT SUMP <br />M <br />L16 <br />794380-304 <br />VENT SUMP BRINE <br />M <br />ri <br />L17 <br />794380-208 <br />DISP 1-2 <br />M <br />0 <br />L18 <br />794380-304 <br />DISP 1-2 BRINE <br />M <br />0 <br />L19 <br />794380-208 <br />DISP 3-4 <br />M <br />0 <br />L20 <br />794380-304 <br />DISP 3-4 BRINE <br />M <br />0 <br />L21 <br />794380-208 <br />DISP 5-6 <br />® <br />0 <br />L22 <br />794380-304 <br />DISP 5-6 BRINE <br />® <br />0 <br />L23 <br />794380-208 <br />DISP 7-8 <br />® <br />0 <br />L24 <br />1 794380-304 <br />1DISP 7-8 BRINE <br />® <br />0 <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 3of6 <br />