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Underground Storage Tank <br /> Monitoring System Certification Form <br /> S. SENSOR TESTING RESULTS <br /> List only sensors tested on date of this certification. List "Sensor 1D"as labeled in system <br /> ' programming. Additional copies of this page may be attached to accommodate all sensors tested. <br /> ,Sensor?D Sensor ModelComponent(s) Monitored Pass Fail <br /> LI VR 208 Dispenser 1-2 ® ❑ <br /> L2 VR 304 Dispenser 1-2 Brine ® ❑ <br /> L3 VR 208 Dispenser 3-4 9 Q <br /> L4 VR 304 Dispenser -4 Brine 0 E) <br /> L5 VR 208 Dispenser -6 0 ❑ <br /> LG VR 304 Dispenser 8-6 Brine ® ❑ <br /> L7 VR 208 Dispenser 7-8 ® ❑ <br /> LS VR 304 Dispenser 7-8 Brine ® ❑ <br /> L9 VR 303 Regular Annular 0 ❑ <br /> L90 VR 303 DiesellPremium Annular X 11 <br /> LI I VR 208 Hent Box ® ❑ <br /> L12 VR 304 Vent Box Brine 9 ❑ <br /> L13 VR 208 Regular STP 0 0 <br /> L14 VR 304 Regular STP Bane a ❑ <br /> L15 VR 208 Regular Fill ® ❑ <br /> L16 VR 304 Regular Fill Bane ISI ❑ <br /> L17 VIS 208 Premium STP 0 ❑ <br /> L18 VR 304 Premium STP Brine 0 L3 <br /> L19 VR 208 Premium Fill ® El <br /> L20 VR 304 Premium Fill Brine IR [71 <br /> L21 VR 208 Diesel STP 0 0 <br /> L22 VR 304 Diesel STP Brine ® ❑ <br /> L23 VR 208 Diesel Fill ® ❑ <br /> L24 VR 304 Diesel Fill Brine ❑ <br /> Describe all answers marked "No"or °Fart"and proposed remedy in Section 9. <br /> List all monitoring equipment either replaced or repaired in Section 9 <br /> Page 3of <br />