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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 /> L1 794380-208 Dispenser 1 & 2 ✓❑ ❑ <br /> L2 794380-208 Dispenser 3 & 4 ✓❑ ❑ <br /> L3 794380-208 Dispenser 5 & 6 ❑✓ ❑ <br /> L4 794380-208 Dispenser 7 & 8 ✓❑ ❑ <br /> L5 794380-208 Dispenser 9 & 10 ✓❑ ❑ <br /> L6 794380-208 Dispenser 11 & 12 ❑✓ ❑ <br /> L7 794380-208 Dispenser 13 & 14 ✓❑ ❑ <br /> L8 794380-208 Dispenser 15 & 16 ❑✓ ❑ <br /> L9 794390-420 87 Annular ❑✓ ❑ <br /> L10 794390-420 91 / Diesel Annular ✓❑ ❑ <br /> L11 794380-208 87 STP Sump ❑✓ ❑ <br /> L12 794380-208 91 STP Sump ❑✓ ❑ <br /> L13 794380-208 Diesel STP Sump ✓❑ ❑ <br /> L14 794380-208 87 Fill sump ❑✓ ❑ <br /> L15 794380-208 91 Fill sump ❑✓ ❑ <br /> L16 794380-208 Diesel Fill sump ❑✓ ❑ <br /> L17 794380-208 Vent sump ❑✓ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <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 />