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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM (pans xot si <br /> VI. INVENTORY OF EQUIPMENT CERTIFIED <br /> FA separate lNonitari 5 tem Ceri tcadon Form must ba reparedforeach monitoring system contm1panah <br /> ntloring System Control Panel Modal oiMonitoring System Control Panel Software Version installed <br /> Veeder Root TILS 350 333402 <br /> Chock the ap <br /> propriate boxes to Indicate s ecift equipment In cted/aervk <br /> Monitwing Device Used I Device Model # monitoring Device Used I Device Model # <br /> TANK 106 87 T1 TANK ID: 91 T2 <br /> B fanknumbar stared etc tank mg9w, scored rrct efa <br /> ® !rn•Tw* Gauging (SW Tank) 847390409 8 lWTank Gaugbng (Sw rank) 847390. 109 <br /> 0ArmutarSpace orvaurisensor 794390.409 Ox Annular Space or Vault Sensor 794390.409 <br /> 0 VPH Samar 0 VPH Sensor <br /> Product Piping Product Piping <br /> 0 Medi Cal LLD 0 Mechanical LLD <br /> ® mactrodc LLD 8484-80 ® Electronic LLD 8484.80 <br /> 0 VPH Sensor (Piping) 0 VPH Semon (PIPIng) <br /> ® sump sensor 794380-208 ® Sump Sensor 794380e208 <br /> 0 VPH Sensor (Sump) 13 VPH Straw (Sump) <br /> Fie Piping Ful Piping <br /> 0VPH Sensor (PWW 0VPH Samar (Ptp ) <br /> 0 Sump Sensor 0 Sump Samar <br /> 0 VPH Sensor (Sump) D VPH Sesser (Sump) <br /> Vont Piping Vent Plying <br /> 0 VPN Sensor (Pipkng) O VPH Sensor (Piping) <br /> 0 Sump Sensor 0 Swap Sensor <br /> 0 VPH Sensor (Sump) 0 VPH Sensor (Swap) <br /> Vapor Recovery Piping Vapor Rocowry Piping <br /> 0 VPH Sensor (Piping) 0 VPH Sensor (Pipkng) <br /> E3 Sip w Sasser 0 Sump Sensor <br /> 0 VPH Samar (Sump) 0 VPH Sensor (Sump) <br /> Moriltorina Device Used Device Model # Altoitor(n Device Used Device Madel # <br /> TANK ID: DSI. T3 <br /> a TANK iD: <br /> tank number stomd ud ata tank siored ud air. <br /> ® In•Tenk Gat*v ISw rank) 847390409 0 (n*Tw* gauging (Sw rank) <br /> M AmuAw Space orv8u9 Sasser 794390409 0 Annular Spm or Vault Sensor <br /> 0 VPH Sensor © VPH Seroor <br /> Product Piping Product PIPing <br /> 0 Mechankai LLD O Machwgw LLD <br /> ® Electronic LLD 848440 C3 Electronic LLD <br /> 13 VPH Sensor (Plying) 0 VPH sensor (Piping) <br /> Sunni) sensor 794380408 1:1 sump sensor <br /> 0 VPH Sensor (Sump) 0 VPH Sensor (Sump) <br /> Fill Piping Fill Piping <br /> D VPH Sensor (PI Ing) 0 VPH Samar (Pkping) <br /> Cl Strip Samar 0 Sump Sensor <br /> 0 VPH Samar (Sump) 0 VPH Sensor (Sump) <br /> Vent Piping Vant Plptng <br /> 0 VPH Samar (Pipinng) 0 VPH Sensor (Piping) <br /> 0 Sump Sensor 0 sump Sensor <br /> 0 VPH Sensor (Sump) 0 VPH Sansar (Sump) <br /> Vapor Recovery Piping Vapor Recovery Piping <br /> 0 VPH Sensor (Piping) 0 VPH Sensor (Pi ) <br /> 0 sump Sensor 0 Sump Sensor <br /> 0 VPH Sensor (Sump) I 0 VPH Sansor ( P) <br /> len SWR , 1r4eMb ed,VPH= LLD = thleLeakDeEedar <br />