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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 /> S 1 ULS DISPENSER 1-2 ❑✓ ❑ <br /> S 2 ULS DISPENSER 3-4 F21 ❑ <br /> S 3 ULS DIESEL STP SUMP 0 ❑ <br /> S 4 ULS 87 STP SUMP ❑✓ ❑ <br /> S 5 ULS 91 STP SUMP 0 ❑ <br /> S 6 ULS 87 ANNULAR SPACE ❑✓ ❑ <br /> S 7 ULS DIESEL / 91 ANNULAR SPACE 0 ❑ <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 />