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Underground Storage Tank <br /> Monitoring System Certification Form <br /> Date site plan was prepared: 10/2112021 <br /> If a site plan has been prepared that shows all required information, you may include it, rather than this page, <br /> with your Monitoring System Certification Form. The site plan must show the general layout of tanks and <br /> identify locations of the monitoring panel, and all leak detection equipment and monitoring locations. Include <br /> a legend for all symbols depicted. <br /> a; Pat <br /> tt <br /> silo 17rC) <br /> „ i. , , ,X�y,,.c , <br /> 0, 0" <br /> i <br /> Flis It <br /> IF <br /> AL it <br /> of <br /> 6 IF <br /> Fg +11 1 It 1 0 a <br /> Yom-° <br /> q ut 3�vsl AlO 146 <br /> is <br /> IF <br /> I Fast'. <br /> it <br /> a Fit <br /> ad <br /> IF ad IF <br /> 06"F add <br /> ; . ,Met <br /> , <br /> _r -- ' <br /> OCT 18 2022 <br /> ENVIRONMENTAL HEALTH <br /> DEPARTMENT Page 6 of 6 <br />