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Automatic line leak detectors will be installed on pressurized piping <br /> Manufacturer:_ Model:---- <br /> R <br /> odel:____ <br /> Re-,^C)Qe, k �-% ,IS <br /> ____ Annual monitoring will be conducted on the pressurized piping with secondary containment. <br /> ____ Annual line tightness test will not be required if the continuous monitor shuts down the pump <br /> and activates the alarm system when a release is detected and when the continuous monitoring <br /> system fails or is disconnected. <br /> OTHER PERTINENT INFORMATION <br /> 20. State Water Resources Control Board"Facility(A)"and"Tank Permit(B)"application forms submitted. <br /> 21. _ ✓ Plan review and operating permit fees paid. <br /> 22. _ ✓_ What is the approximate depth to ground water: <br /> r (include source of information-borehole logs,monitoring well data,water <br /> studies, etc.) <br /> 23. ____ Location of all existing sewer lines,septic tank,pits and lines, and well(s)indicated on plans. <br /> 24. _ Total number of tanks on site after installation: <br /> 25. Yt- <br /> ,2 County/City Fire District and Building Department notified. <br /> 26. ____ In the event contamination is observed,confirmed or suspected as a result of a leaking UST system it is your <br /> responsibility[in accordance with(CCR)Title 23,Division 3,Chapter 16,Article 11,Corrective Action <br /> Requirements]as an owner or operator to submit a workplan to EHD Site Mitigation Unit prior to initiating any <br /> assessment or remediation activities. For further assistance contact the Site Mitigation Unit at(209)469-3450. <br /> // The owner or operator must acknowledge this responsibility for workplan submittal by signature and date below. <br /> Name_ GFX_ �[.� _ Title Q er�4 (Qrl/ � /9 ZY^_Date L=?,Cl"0 3 <br /> CONDITIONS OF APPROVAL: <br /> 9 <br />