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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 lD Sensor Model Component(s) Monitored Pass Fail <br /> S10 330020-463/330020-464 87 VENT LINE ❑✓ ❑ <br /> S11 330020-463/330020-464 VAPOR RETURN LINE ❑✓ ❑ <br /> S12 330020-463/330020-464 91 PRODUCT LINE i✓ ❑ <br /> S13 330020-463/330020-464 91 VENT LINE 0✓ ❑ <br /> 0 ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> 0 ❑ <br /> 0 ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> © ❑ <br /> 0 ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> © ❑ <br /> 0 ❑ <br /> ❑ ❑ <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 3of6 <br />