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i <br />Site Address: 10 E. 12TH ST., T e of Testing/Servicing:d� <br />Monitoring System Certification <br />UST Monitoring Site Plan <br />...................................................... <br />...................................................... <br />777 ..... .. . ............ <br />................... ... 0 ............ .. <br />...................... <br />.............................. ..... <br />...................................�,� 1� . <br />.............................. <br />......... <br />.... ....... <br />............ .. ............ <br />............:.... . <br />Date map was drawn: b / l 1/ 0 <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 />Page of 05/00 <br />