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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM ( Page 6 of 6) <br /> XVI . MONITORING SITE PLAN <br /> Date site map was prepared : <br /> If you already have a site plan that shows all required information, you may include it, rather than this page, with your Monitoring System <br /> Certification Form. The site plan must show the general layout of tanks and piping and clearly identify locations of the following <br /> equipment, if installed: 1) monitoring system control panels; 2) in-tank liquid level probes (if used for leak detection); 3) devices <br /> monitoring tank annular spaces or vault; 4) devices monitoring product piping; 5) devices monitoring fill piping; 6) devices monitoring vent <br /> piping; 7) devices monitoring vapor recovery piping; 8) devices monitoring vent/transition sumps; 9) devices monitoring under-dispenser <br /> containment; 10 line leak detectors; and 11 devices monitoring any other secondaty containment areas. <br /> F EB 0 7 2020 <br /> ENVIRONMENTAL HEALTH <br /> DFPARTI\.AENT <br /> DA VINCI , . <br /> L4 B <br /> FV <br /> L3 F ,Ilit }4i, <br /> L=SFNS0k REG <br /> F=F♦I7LrLYL <br /> A=PROBES <br /> ESO=EMERGENc Y S--r0P VRr <br /> I=ANNLILAR 741 #20332 BW <br /> Wk=V LEDERIWO `I' 4627 DA WNCI DR <br /> BkKS=BkE? AKhRS STOCKTON, CA. 93207 <br /> cas <br />