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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 ID Sensor Model Component(s) Monitored Pass Fail <br /> L - 1 3 5 2 87 OCTANE S T P SUMP 0 ❑ <br /> L - 2 3 5 2 91 OCTANE S T P SUMP El ❑ <br /> L - 3 3 5 2 DIESEL S T P SUMP 0 ❑ <br /> L - 4 3 0 3 87 OCTANE ANNULAR SPACE 0 ❑ <br /> L - 5 3 0 2 91 OCTANE ANNULAR SPACE 0 ❑ <br /> L - 6 3 0 2 DIESEL ANNULAR SPACE 0 ❑ <br /> ❑ ❑ <br /> FLOATS & CHAINS ❑ ❑ <br /> 87 ADJSTD DISPENSER 1 / 2 0 ❑ <br /> DISPENSER 3 / 4 0 ❑ <br /> DISPENSER 5 / 6 0 ❑ <br /> DISPENSER 7 / 8 0 ❑ <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 />