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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM (Page s of s) <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 A4pnitori , g; System <br /> Certification Form. The site plan must show the general layout of tanks and piping and clearly identify loc6tiohs of the following equipment, <br /> if installed: 1) monitoring system control panels; 2) in-tank liquid level probes (if used for leak detection); 3) devices monitoring tank <br /> annular spaces or vault; 4) devices monitoring product piping; 5) devices monitoring fill piping; 6) devices monitoring vent piping; 7) devices <br /> monitoring vapor recovery piping; 8) devices monitoring vent/transition sumps; 9) devices monitoring under-dispenser containment; 10) <br /> line leak detectors; and 11) devices monitoring any other secondary containment areas. <br /> UST Monitoring Site Plan <br /> ---- - --- - — - -- - -- - - - - - - - - - -- - <br /> SheAddres-s:_ ' LODI MEMORIAL HOSPITAL 975 FAIRMONT AVENUE LODI CA 95240 <br /> *PIPU�G * . . _ . . _ <br /> Drawing of piping <br /> exit of sump and <br /> UDC's. Xo f-- �� Fl F2 <br /> underground <br /> drawing is accurate 1` /1 tent �J <br /> we cannot <br /> speculate bine p GEN X <br /> prints. _ TLS <br /> T x <br /> i . Day Tanks <br /> Fent <br /> . <br /> HOSPITAL . . . . . . . . . . . . . <br /> _ - - ole Fill <br /> OVERFILL ,n - KEY <br /> A = .ANULAR <br /> F = FILLS <br /> 3sys�ik _ . . . . . _ T = TURE NE <br /> P = PROBE <br /> . . . . . V = VAPOR <br /> R = SUMP SENSOR <br /> L = Leak Detector <br /> BUILDING I,I = ?Mannas• <br /> B = Brine Sensor <br /> I = Smart Sensor <br /> S = STP <br /> C =Floats & Chaim <br /> . . . . . . - _ _ E = E Stop <br /> -4rik• iren¢ en-47 nor risible to t1a cer7;(iin�g reciaticiarr rax• a <br /> p essicrnlopitacvtora4nrrin'esdeii ,ja rt�otnnttcanlpnlrcc. Drmrill <br /> rarrroscale <br /> Date crap was drawn 10-28- 17 <br /> Instructions <br /> If you already have a diagram that shows as 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 locators of the following equipment, if installed: monitoring system control panels; sensors monhoring tank <br /> annular spaces, sumps , dispenser pans, spill wntainers, or other secondary containment areas: mechanical or electrons, line leak detectors; and in-tank liqu!d level <br /> probes (if used for leak detecbon). In the sEace provided, note the data this Site Plan was prepared, <br /> LEGEND <br />