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UNDERGROUND STORAGE TANK <br />MONITORING SYSTEM CERTIFICATION FORM (Page 6 of 6) <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 Monitoring System <br />Certification Form. The site plan must show the general layout of tanks and piping and clearly identify locations 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 />annularspaces or vault, 4) devices monitoring product piping; 5) devices monitoring fil/piping; 6) devices monitoring ventpiping; 7) devices <br />monitoring vapor recovery piping; 8) devices monitoring venbtransition sumps; 9) devices monitoring under -dispenser containment; 10) <br />line leak detectors; and 11) devices monitoring any other secondary containment areas. <br />UST Monkoring Site Plan <br />Site Address: 1769 W CHARTER WAY STDCKTDN. CA <br />. . . . . . . . . . . . . . . . . . . . . <br />. . . . . . . . . . . . . . . . . . . <br />. . . . . . . . . . . . . . . . . . . . . . . . . . <br />............................. <br />............................. <br />............................. <br />............................. <br />............................. <br />............................. <br />............................. <br />............................ <br />............................. <br />. <br />.4 . . . . . . <br />2 . . . . . . . . . . . . . . . . . . . . . . <br />............................. <br />............................. <br />............................. <br />............................. <br />............................. <br />............................. <br />............................. <br />............................. <br />............................. <br />............................. <br />............................. <br />............................ <br />............................. <br />. ....... .............. <br />T X T X <br />*PIPING* <br />ft9TROWS) <br />Dxawim cr pipixtg <br />exit sump axil <br />UDC's. No <br />uxdergouni <br />dzawirg is <br />acaxxate,we <br />caxatot s peaxlate <br />blue pxixds. <br />_initem: « xziet;grrnoxd that m� trot tfsible to tla- cerf(fifn� t<rlartcirr« ae a <br />A-gkssicrrtf oyitrimt or>{amrf m -e scle{ifa-ird'onrntiorrlyraFrc s. Di�rin� <br />rxtt to sccde <br />Dare map was drawn D3f28118 <br />Instructions <br />M you already haves dtagramtha[shows all required Infortnatton, you mayindu de it, ratherthan this page, wfth }our Nbnitoring System Certifcation. Dn your s'roe plan, <br />show the general layout oftanks and piping. Clears ytdentify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank <br />ann ular sp aces, sumps, dispenser pans, spill containers, o r othe rseeondary containment a teas; meth anioal or electron to line leak detectors; and in -tank l iquid level <br />probes (if used for leak detection). In the spaoe provided, notethe date this Site Plan was prepared. <br />R F C k 11 L <br />r <br />APS 19 2019 <br />ENVIRONMENTAL H <br />EALTH <br />!.?FR:4l�TMEI�T <br />