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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 lD Sensor Model Component(s) Monitored Pass Fail <br /> L - 1 4 0 9 91 OCTANE ANNULAR SPACE 0 ❑ <br /> L - 2 4 0 9 MASTER 87 OCTANE ANNULAR SPACE 0 ❑ <br /> L - 3 4 0 9 SLAVE 87 OCTANE ANNULAR SPACE 0 ❑ <br /> L - 4 4 0 9 DIESEL ANNULAR SPACE 0 ❑ <br /> L - 5 208 91 OCTANE S T P SUMP 0 ❑ <br /> L - 6 2 0 8 MASTER 87 OCTANE S T P SUMP 0 ❑ <br /> L - 7 208 SLAVE 87 OCTANE S T P SUMP 0 ❑ <br /> L - 8 2 0 8 DIESEL S T P SUMP 0 ❑ <br /> L - 9 2 0 8 91 OCTANE FILL SUMP 0 ❑ <br /> L - 10 2 0 8 MASTER 87 OCTANE FILL SUMP 0 ❑ <br /> L - 11 2 0 8 SLAVE 87 OCTANE FILL SUMP 0 0 <br /> L - 12 2 0 8 DIESEL FILL SUMP 0 ❑ <br /> L - 13 2 0 8 DISPENSER 1 / 2 0 ❑ <br /> L - 14 2 0 8 DISPENSER 3 / 4 0 ❑ <br /> L - 15 2 0 8 DISPENSER 5 / 6 0 ❑ <br /> L - 16 2 0 8 DISPENSER 7 / 8 0 ❑ <br /> L - 17 2 0 8 DISPENSER 9 / 10 0 ❑ <br /> L - 18 2 0 8 DISPENSER 11 / 12 0 ❑ <br /> L - 19 2 0 8 VENT SUMP 0 ❑ <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 />