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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 2 0 8 DISPENSER 1 / 2 0 ❑ <br /> L - 2 3 0 4 DISPENSER 1 / 2 BRINE 0 ❑ <br /> L - 3 2 0 8 DISPENSER 3 / 4 0 ❑ <br /> L - 4 3 0 4 DISPENSER 3 / 4 BRINE 0 ❑ <br /> L - 5 2 0 8 DISPENSER 5 / 6 0 ❑ <br /> L - 6 3 0 4 DISPENSER 5 / 6 BRINE 0 ❑ <br /> L - 7 2 0 8 DISPENSER 7 / 8 0 ❑ <br /> L - 8 3 0 4 DISPENSER 7 / 8 BRINE 0 ❑ <br /> L - 9 2 0 8 DISPENSER 9 / 10 0 ❑ <br /> L - 10 3 0 4 DISPENSER 9 / 10 BRINE 0 ❑ <br /> L - 11 2 0 8 DISPENSER 11 / 12 0 ❑ <br /> L - 12 3 0 4 DISPENSER 11 / 12 BRINE ❑ 0 <br /> L - 13 2 0 8 VENT BOX 0 ❑ <br /> L - 14 3 0 4 VENT BOX BRINE 0 ❑ <br /> L - 15 208 87 OCTANE S T P SUMP 0 ❑ <br /> L - 16 3 0 4 87 OCTANE S T P SUMP BRINE 0 ❑ <br /> L - 17 2 0 8 87 OCTANE FILL SUMP 0 ❑ <br /> L - 18 3 0 4 87 OCTANE FILL SUMP BRINE 0 ❑ <br /> L - 19 208 91 OCTANE S T P SUMP 0 ❑ <br /> L - 20 3 0 4 91 OCTANE S T P SUMP BRINE 0 ❑ <br /> L - 21 N / A MOVED TOL - 22 / DW2 - 1 ❑ ❑ <br /> L - 22 3 0 4 - 2 0 8 91 OCTANE FILL SUMP BRINE ❑ 0 <br /> L - 23 2 0 8 DIESEL S T P SUMP 0 ❑ <br /> L - 24 3 0 4 DIESEL S T P SUMP BRINE 0 ❑ <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 />