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Underground Storage Tank <br />Monitoring System Certification Form <br />si rim ►yiIQ1!111101N1Z![1154k9=1»_1► <br />Date site plan was prepared: <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 />Site address: <br />UST Monitoring Site Plan <br />Stockton Mobil #1 - 642 N HUNTER ST Stockton CA 95204 <br />T <br />G..........WASH <br />CAR <br />t <br />I <br />..................................... <br />...................... .......................... <br />MAP KEY: <br />A=ANNULAR SENSOR . .87-2 O DIE.. <br />F=FILL g p O <br />P=PROBE A x O <br />V=VAPOR X P <br />ST=SLAVE TURBINE P <br />L=LEAK DETECTOR/ TURBINE ' ' ' ' ' ' ' ' ' ' ' <br />X=CFNCnR.................................................. <br />87-1 <br />*PIPING * . . . . . . . . . . . . . . . . . . . . . <br />(ARROWS) . . . . . . . . . . . . . . . . Y O . . . . . <br />Drawing of . . . . . . . . . . . . . . . . . . . . <br />piping exit of . . . . . . . . . . . . . .. . . . . <br />sump and nd . . . . . . . . . . . . . . . . . . . . . <br />No underground drawing is . . . . . . . . . . . . . 1 . . . . . . <br />accurate, we "� O('X'��T <br />. . . . . <br />9.cannot speculate . <br />Any items underground that are not visible to the certifying technician are a <br />professional opinion only and are solely for informational purposes. Drawing not to <br />scale. <br />Date map was drawn: 5/15/21 <br />Instructions <br />If you already have a diagram that shows all 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 locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank <br />annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in -tank liquid level <br />probes (if used for leak detection). In the space provided, note the date this Site Plan was prepared. <br />Monitoring System Certification Page 4 of 4 2/21/07 <br />Page 6of6 <br />