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Underground Storage Tank <br /> Monitoring System Certification Form <br /> Date site plan was prepared.10/2112021 <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 /> A IAC O -Joe f%o•►., bo # 92-/-Oz <br /> 2Y3� -�oe. ro.�bo �iN�y <br /> CIA <br /> : . . . . . . . . . . . . l� . .f7.S:3Y2� . . . ' . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . ... . ... . <br /> --- ---; _ --- .. . . . . . . . . . <br /> �.IJB. . . . . . . L '� r . . . " 2 , <br /> Rv� ' . . .'. . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . 12-. . . . . . "to. . . . . <br /> . . . <br /> �i . . . . °�. . . . . . . <br /> X30 <br /> fa- -- . . . . . <br /> rfi ua. . . . . .. . <br /> . . . . . . . . . . . . . <br /> Page 6of6 <br />