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Underground Storage Tank <br />Monitoring y tem 'Certification Form <br />6, SENSOR TESTING RESULTS <br />List only sensors <br />programming. <br />tested on date of <br />Additional copies <br />Sensor Model <br />r,tJy L Cj 6ALTVA7 <br />� � <br />answers marked "No" <br />equipment either <br />this certification. List "Sensor IW as labeled in system <br />of this page may be attached to accommodate all sensors tested. <br />Components) Monitored Pass <br />Q nrN V YL- <br />a vp <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ P❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />or "Fail' and proposed remedy in Section 9. <br />replaced or repaired in Section 9 <br />Fail <br />El <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />Sensor lD <br />Describe all <br />List all monitoring <br />Page 3 of 6 <br />