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W.O.# NW1-2308868 <br />Antivio ATO CeMSCOM -(May 2013}.0 <br />Store <br />6. SENSORS (single wall & double wall systems) <br />Location & <br />Product <br />• STP Stnp <br />• U00 , <br />• INTERSTMAL <br />• FVRSump <br />, Manufactuter <br />o. BLS= Beaudremi <br />o VLS x VeederRoW <br />o OTH - Other <br />Tips <br />0 0 Float <br />o V Vvor <br />a ND -Nora <br />o 0 » D*at�inalirv. <br />Test Method <br />ti S SuWarsl ' on <br />o - F ■ flippingAdtivates <br />6, OTH a bth6r <br />'PRODUCT <br />serial Alarm �Spedifjt: <br />Number YIN Shutdown <br />YIN <br />TOTAL <br />Site <br />Shutdown <br />YfN <br />UL STP <br />VLS <br />ND <br />F <br />123456 Y N, <br />y <br />EII& <br />V <br />-L., <br />I] L.A <br />Aj <br />N <br />7, <br />III <br />L-21 <br />—ULA= <br />A.) <br />(Attach the Print Out) <br />Comments: <br />7. PROBES Remove each oroduct level Probe and inspect for rust. bloloalcai arowth, etc. and clean if necessary. <br />TANK Al OBSERVAMONS SmALNumsER FUEL t,#VEL WATERLEveL <br />Tank # 1 <br />Tank # 2 J011— <br />Tank # 3 <br />Tank 0 4 <br />I certify that the Automatic Tank Gauging and/Qr Leak Detection System is <br />accordance with the manufacturers' specirica rist <br />Technician Name k:--11-nature: <br />('41 9 <br />Testing Company"'- Zh't Date: <br />Address:ell -A--, Phone: <br />PAY - <br />ATTACH COPY OF SYSTEM PROGRAMMING & TEST REsual <br />Page 3 of 3 <br />OYAMYMWAMZ�& M <br />