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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 1D" as labeled in system programming. <br />Additional copies of this page may be attached to accommodate all sensors tested. <br />Sensor lD <br />Sensor Model <br />Component(s) Monitored <br />Pass <br />Fail <br />1-1 <br />794380-208 <br />UDC 1&2 <br />x <br />❑ <br />L2 <br />794380-304 <br />UDC 1&2 DW <br />x <br />O <br />L3 <br />794380-208 <br />UDC 3&4 <br />x <br />O <br />L4 <br />794380-304 <br />UDC 3&4 DW <br />x <br />❑ <br />L5 <br />794380-208 <br />UDC 5&6 <br />X <br />❑ <br />L6 <br />794380-304 <br />UDC 5&6 DW <br />X <br />O <br />L7 <br />794380-208 <br />UDC 7&8 <br />X <br />❑ <br />L8 <br />794380-304 <br />UD 7&8 DW <br />X <br />p <br />L9 <br />794380-208 <br />UDC 9&10 <br />X <br />O <br />L10 <br />794380-304 <br />UDC 9&10 DW <br />X <br />O <br />1-11 <br />794380-208 <br />UDC 11&12 <br />X <br />p <br />L12 <br />794380-304 <br />UDC 11&12 DW <br />X <br />O <br />L13 <br />794380-208 <br />UDC 13&14 <br />X <br />O <br />L14 <br />794380-304 <br />UDC 13&14 DW <br />X <br />O <br />L15 <br />794380-208 <br />UDC 15&16 <br />X <br />O <br />L16 <br />794380-304 <br />UDC 15&16 DW <br />X <br />O <br />L17 <br />794380-208 <br />87 STP SUMP <br />X <br />O <br />L18 <br />794380-304 <br />87 STP SUMP DW <br />X <br />O <br />L19 <br />794380-208 <br />87 FILL SUMP <br />X <br />O <br />L20 <br />794380-304 <br />87 FILL SUMP DW <br />X <br />O <br />L21 <br />794380-208 <br />91 STP SUMP <br />X <br />O <br />L22 <br />794380-304 <br />91 STP SUMP DW <br />x <br />O <br />L23 <br />794380-208 <br />91 FILL SUMP <br />X <br />O <br />L24 <br />794380-304 <br />91 FILL SUMP DW <br />X <br />O <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 />