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RECEIVED <br /> Underground Storage Tank <br /> Monitoring System Certification Form JAN 0 7 <br /> ENVIRONMENTAL <br /> 10> MONITORING SITE PLAN ' HEALTH D <br /> Date site plan was prepared: <br /> If a site plan has been prepared that shows all required information, you may include it, rather than this page, <br /> with your Monitoring System Certification Form . The site plan must show the general layout of tanks and <br /> identify locations of the monitoring panel, and all leak detection equipment and monitoring locations . Include <br /> a legend for all symbols depicted. <br /> S" Address KWIK SERVE 420 KETTLEMAN LANE LORI CA 95240 <br /> 3 <br /> KEY Ana+ itenia=dex eround tlat aze not c-isible to the ceatifi inn technician are 3 <br /> A = Lfttt3} AR Seasor prafe sicaial oginicm onlyand are solely for in&rmatic ial purposes. Draming nater, <br /> F= FILLS : sraie:' <br /> N'=VAPO <br /> P = PROBE <br /> L = TurhmelLeakDetectop ' 8 <br /> Y = SMTP SENSOR „t a <br /> B = Brine Sensor 5.� ' . 7. _ , <br /> S = Smart Sensor <br /> C = Floats & Chains A:Yj <br /> P _ EStop <br /> OF 0 <br /> t . _ Diesel $7 <br /> 'r <br /> oF t <br /> .. . _ . . _. . . .. . 1V V '. 71 <br /> WA <br /> *PIPING a UE OIL <br /> (ARROWS) <br /> Draw*&of pigittg <br /> exit of sump and <br /> UDC' s. 'a'NTTo 1 t 's r <br /> ud o \ � ' d_ . <br /> drawing is acccurate n <br /> k>ie cauno€ <br /> speculate'alue <br /> Prints, 3TC <br /> i <br /> I <br /> Date map was drawn: d,+211211 <br /> Instructions <br /> If you already have.a diagram that shows all required infom ation, you may irclu e it rather than this page, with your Monitoring System certfication:. On your site plan, <br /> l shove tine general Iayoutrf tanks and p1ping. Gleariy alenerfyr icoatrors of the following equipment, of installed rnon:#o ing system control panels; sensors monitonrvq lank <br /> annular spaces, sumps , dispenser pans spill varstainers, or,others�ordary confaiiment areas; mechan cal or e'ec%ronio fine leak detectors; and iinAank ligwd level <br /> i <br /> )v <br /> probes ;if used for leak defeor*n). In the epat.- provided, nate the datothis Site Pan was prepared: <br /> RECEIVED <br /> JAN 0 7 2022 <br /> Page 6 of 6 <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br />