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Underground Storage Tank <br /> Release Detection Equipment Testing Report Form <br /> .. ....... .. ..........:... ............. . <br /> 6. .804 R TEST'RESCILTS <br /> ❑ Check this box if Appendix 5.1 continuation page is attached. <br /> List only sensors tested. List"Sensor ID"as labeled in system programming. For VPH monitoring, <br /> continuity must be confirmed between the most distant points in the interstitial space to the extent <br /> practical as approved by the Unified Program Agency and the sensor that monitors the zone. <br /> Sensor Sensor <br /> 1d Model <br /> Component(s) Monitored rtU . an , G nt�nt t <br /> Pass;r ,Faii> ';Pass`'PF <br /> #1 847999-001UDC #1 Diesel ❑#2 847990-9Q1 UDC#2 [Unleaded ® ❑ ❑ EZ <br /> ❑ ❑ ❑ ❑❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ F ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ <br /> Describe all answers marked Wo"or"Fail"and the proposed remedy in Section S. <br /> List all equipment either replaced or repaired(including cleaning or adjustment) in Section S. <br /> Page 3 of 6 <br />