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i <br />Monitoring System Certification <br />UST Monitoring Site <br />Site Address: /� _ o J "-5's �- <br />.............. ...... 11 �9) .. ....................... <br />.............. .....*r....... ......................I <br />.............. .............. ....................... <br />....................... <br />............................. ....................... <br />.............. .............. ....................... <br />....................................: ............. <br />................................. <br />..................................5 �Qg. <br />. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br />. <br />....................................... ... ......... <br />.................................. 0. <br />�' <br />............. ...... ............ .. ......... <br />......................................... ....... .. <br />........................................................ <br />....................................................... <br />...................................................... <br />..................................................... <br />..................................................... <br />.................:.................................... <br />...................................................... <br />..................................................... <br />..................................................... <br />Date map was drawn: q/ Iq / <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 />l�Page of <br />