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Underground Storage Tank <br />Monitoring System Certification Form <br />16. 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 lD <br />Sensor Model <br />Component(s) Monitored <br />Pass <br />Fail <br />L-1 <br />208 <br />91 STP <br />0 <br />❑ <br />L-2 <br />208 <br />87-1 STP <br />F21 <br />❑ <br />L-3 <br />208 <br />87-2 stp <br />0 <br />❑ <br />L-4 <br />208 <br />DIESEL STP <br />0 <br />❑ <br />L-5 <br />420 <br />91 AN N U LAR <br />0 <br />❑ <br />L-6 <br />420 <br />87-1 ANNULAR <br />0 <br />❑ <br />L-7 <br />420 <br />87-2 ANNULAR <br />0 <br />❑ <br />L-8 <br />420 <br />DIESEL ANNULAR <br />0 <br />❑ <br />DISP 1-3 <br />001 <br />UDC <br />IZI <br />❑ <br />DISP 2-4 <br />001 <br />UDC <br />[Z] <br />❑ <br />DISP 5-7 <br />001 <br />UDC <br />IZI <br />❑ <br />DISP 6-8 <br />001 <br />UDC <br />0 <br />❑ <br />DISP 9-11 <br />001 <br />UDC <br />❑✓ <br />❑ <br />DISP10-12 <br />001 <br />UDC❑ <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 6 <br />