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a <br />It <br />UNDERGROUND STORAGE TANK MONITORING SYSTEM CERTIFICATION <br />Permit Number: <br />UST Monitoring Site Plan <br />Site Address: 2iz N Cc °- r n <br />. . . . . . . . . . .AI. . . . . . . .0' 0 0. . . . . . . . . . . <br />. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .i/�, . . vC:''". .. . . . . . . . . . . <br />.......... ... .....I. ..�`.................... <br />..................� ........................... <br />-�- ... ... (60. . b$A �.............. <br />...... . . .Q. . . . .. . . . . . . . . . . .... .... ...... <br />.............. ........ .................... <br />.............. .... ............................... <br />............................. ..................... <br />�.�............ ..... .� <br />D$� �h��. . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . <br />..................... ... .......... <br />....... <br />......... ........... I ....... <br />�� <br />M . . . . . .:::::: ;�.............. <br />................................ <br />.......... I ....... <br />.. <br />................. <br />._..��, ................. <br />.......... <br />.... ....mak.. ..... <br />a...... ............ <br />V/1R. <br />Date map was drawn: 61 /%S / n C <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 thefollowing 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 />