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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 <br />Sensor Model <br />Component(s) Monitored <br />Pass <br />Fail <br />L1 <br />794380-303 <br />T1 Unleaded 87A Annular Sensor <br />® <br />❑ <br />L2 <br />794380-303 <br />T2 Unleaded 87B Annular Sensor <br />® <br />❑ <br />L3 <br />794380-303 <br />T3 Unleaded 91 Annular Sensor <br />® <br />❑ <br />L4 <br />794380-303 <br />T4 Additive Annular Sensor <br />® <br />❑ <br />L5 <br />794380-303 <br />T5 Unleaded Additive Annular Sensor <br />® <br />❑ <br />L9 <br />794380-323 <br />T1 Unleaded 87A Fill Sump Sensor <br />® <br />❑ <br />L10 <br />794380-323 <br />T1 Unleaded 87A Turbine Sump Sensor <br />® <br />❑ <br />L11 <br />794380-323 <br />T2 Unleaded 87B Fill Sump Sensor <br />® <br />❑ <br />L12 <br />794380-323 <br />T2 Unleaded 87B Turbine Sump Sensor <br />® <br />❑ <br />L13 <br />794380-323 <br />T3 Unleaded 91 Fill Sump Sensor <br />® <br />❑ <br />L14 <br />794380-323 <br />T3 Unleaded 91 Turbine Sump Sensor <br />® <br />❑ <br />L15 <br />794380-323 <br />T5 Unleaded 87C Fill Sump Sensor <br />® <br />❑ <br />L16 <br />794380-323 <br />T5 Unleaded 87C Turbine Sump Sensor <br />® <br />❑ <br />L17 <br />794380-323 <br />Dispenser 1-2 Sump Sensor <br />® <br />❑ <br />L18 <br />794380-323 <br />Dispenser 3-4 Sump Sensor <br />® <br />❑ <br />L19 <br />794380-323 <br />Dispenser 5-6 Sump Sensor <br />® <br />❑ <br />L20 <br />794380-323 <br />Dispenser 7-8 Sump Sensor <br />® <br />❑ <br />L21 <br />794380-323 <br />Dispenser 9-10 Sump Sensor <br />® <br />❑ <br />L22 <br />794380-323 <br />Dispenser 11-12 Sump Sensor <br />® <br />❑ <br />L23 <br />794380-323 <br />Dispenser 13-14 Sump Sensor <br />® <br />❑ <br />L24 <br />794380-323 <br />Dispenser 15-16 Sump Sensor <br />® <br />❑ <br />L25 <br />794380-323 <br />Dispenser 17-18 Sump Sensor <br />® <br />❑ <br />L26 <br />794380-323 <br />Dispenser 19-20 Sump Sensor <br />® <br />❑ <br />L27 <br />794380-323 <br />Dispenser 21-22 Sump Sensor <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 3 of 6 <br />