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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 1 420 DIESEL ANNULAR SPACE ❑✓ ❑ <br /> L 2 205 DIESEL STP SUMP ❑✓ ❑ <br /> L 3 420 91 ANNULAR SPACE ✓❑ ❑ <br /> L 4 205 91 STP SUMP ❑✓ ❑ <br /> L 5 420 87 ANNULAR SPACE ❑✓ ❑ <br /> L 6 208 87 STP SUMP ❑✓ ❑ <br /> ❑ ❑ <br /> CHAINS AND FLOAT DISPENSER 1-2 0 ❑ <br /> CHAIN AND FLOAT DISPENSER 3-4 ❑✓ ❑ <br /> CHAIN AND FLOAT DISPENSER 5-6 ❑✓ ❑ <br /> CHAIN AND FLOAT DISPENSER 7-8 ❑✓ ❑ <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 />