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UNDERGROUND STORAGE TANK MONITORS tG SYSTEM CERTIFICATION <br /> Permit Number: <br /> UST Monitoring Site Pian <br /> Siie Address: <br /> . . . . . . . . . . . . . . . . . t,,✓1 c V1; : " ►? . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . , . . . . . . . . . . . . <br /> . . . Y <br /> . . . . . . . . . . . � . <br /> Vl` . <br /> . . `o . = �. � u : . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : : .. . . . . . . . : : : : <br /> . . . ; <br /> . . . . . . . (- �r . <br /> . . . . . . . . . . : . � � a fl :� .v. . <br /> � . . . . . . . . . : : : ': � <br /> . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .. . .0 <br /> . . . . . . . . . . . J. <br /> . U <br /> .lam-: 11Vff ,� <br /> .w. . <br /> -------------- <br /> ..._ - <br /> �. <br /> . o . <br /> . . . . . . . . . . . . . . . . . . . . . . . . • o . <br /> . `'So . <br /> ./. s i• . . . . . <br /> . . . . . . . . . . .. . . / d <br /> . . . . <br /> . . .__-.._ _ _.-r. . . .�. . . . . . . . . . . . . .. . . <br /> . . . . . . . . . . . . . . r- . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . <br /> Date map was drawn: <br /> Instructions <br /> If you already have a diagram that shows all required information, you may include it, rather than this page, with your <br /> Monitoring System Certification. On your site plan, show the- general layout of tanks and piping. Clearly identify <br /> locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular <br /> spaces, sumps,dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak <br /> detectors; and in-tank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan <br /> was prepared. <br />