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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 5. SENSOR TESTING RESULTS <br /> List only sensors fested on date of this certification. List"Sensor ID"as labeled in system <br /> programming. Additional copies of this page maybe attached to accommodate all sensors tested. <br /> sensor lD sensor Model Component(s) Monitored Pass Fail <br /> L1 794380-209 Supreme stp 0 0 <br /> L2 794380-209 Regular 2 stp z 0 <br /> L3 794380-209 Regular1 stp Z 0 <br /> L4 794390-407 Supreme annulas ® El <br /> L5 794390-407 Reg 2 annulas 0 El <br /> L6 794390-407 Reg 1 annulas 0 El <br /> L7 794380-208 Dispenser 1-2 Ij <br /> L8 794380-208 Dispenser 3-4 Ij <br /> L9 794380-208 Dispenser 5-6 ® Lj <br /> L10 794380-208 Dispenser 7-8 ® Lj <br /> 111 794380-208 Dispenser 9-10 ® Lj <br /> L12 794380-208 Dispenser 11-12 z L) <br /> L13 794380-209 Supreme FII 0 L) <br /> L14 794380-209 Reg2 fill R) L) <br /> L15 794380-208 Reg1 fill ® 11 <br /> Ll 11 <br /> Ll 11 <br /> Ll 11 <br /> U 11 <br /> Li El <br /> L1 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 />