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UST Monitoring Site Plan <br />Site Address: LODI MEMORIAL HOSPITAL 975 FAIRMONT AVENUE LODI CA 95240 <br />Date map was drawn / / <br />Instructions <br />�j <br />If you already have a diagram that shows all required information, you may include it, rather than this page, with your Monitoring System Certification. On your site plan, <br />show the general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank <br />annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in -tank liquid level <br />probes (if used for leak detection). In the space provided, note the date this Site Plan was prepared. <br />4 of 4 <br />