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UNDERGROUND STORAGE TANK MONITORING PLAN - PAGE 2 VI. DISPENSER MONITORING MONITORING OF AREAS BENEATH DISPENSER(S) IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) M50. Q 1. CONTINUOUS MONITORING OF UNDER DISPENSER CONTAINMENT (UDC) PANEL MANUFACTURER: Veeder Root 1051. MODEL #: TLS 350 R M52. LEAK SENSOR MANUFACTURER: Veeder Root M53. MODEL #(S): 794380-208 M54. WILL DETECTION OF A LEAK IN THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? X❑ a. YES F] b. NO Mss. WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN?x❑ a. YES b. NO M56. WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? a. YES b. NO M57. 2. MECHANICAL CONTINUOS MONITORING (e.g., FLOAT AND CHAIN ASSEMBLY) IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK MANUFACTURER: Mss. MODEL #(S): M59. 3.VISUAL MONITORING DONE: R a. DAILY ❑ b. WEEKLY M60. 4. NO DISPENSERS ❑ 99. OTHER (Specify) M61. VII. ENHANCED LEAK DETECTION 1. WE HAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT WE MUST PERFORM ENHANCED LEAK 70' DETECTION (ELD) FOR THE UST(S) COVERED BY THIS PLAN. PER 23 CCR §2644.1, ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED VIII. TRAINING REFERENCE DOCUMENTS MAINTAINED AT FACILITY (Check all that appy Mao. 1. Fx THIS UNDERGROUND STORAGE TANK MONITORING PLAN (Required) 2. OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT (Required) 3. X THE FACILITY'S BEST MANAGEMENT PRACTICES (Required as of January 1, 2005) 4. CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 5. CALIFORNIA UNDERGROUND STORAGE TANK LAW 6. STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION" 7. SWRCB PUBLICATION: "WEEKLY MANUAL TANK GAUGING FOR SMALL UNDERGROUND STORAGE TANKS" 99C] OTHER (Specify): Mal. Personnel with UST monitoring responsibilitiesfamiliar s when needed. By January 1, 2005, this facility will have a "Designated UST Operator" who has passed the California UST Sytem Operator Exam administered by the International Code Council (ICC). By July 1, 2005, and annually thereafter, the "Designated UST Operator" will train facility employees in the proper operation and maintenance of the UST systems. This training will include, but is not limited to, the following: O Operation of the UST systems in a manner consistent with the facility's best management practices. O The facility employee's role with regard to the leak detection equipment. © The facility employee's role with regard to spills and overfills. O Whom to contact for emergencies and leak detection alarms. For facility employees hired on or after July 1, 2005, the initial training will be conducted within 30 days of the date of IX. COMMENTS/ADDITIONAL INFORMATION Please use this section to include any additional system monitoring -related information e.g., additional information required by your local Mas. agency): X. PERSONNEL RESPONSIBILITIES "DIESK3 AS OF JANUARY 1, ZOU5, I HL OR" IDENTIFIED IN SE( -TION III OFTHECURRENT L15TOPERAIINU PLRIVIII APPLICATION -FACILITY FORM WILL HAVE ULTIMATE AUTHORITY FOR PERFORMING THE MONITORING ACTIVITIES AND MAINTAINING LEAK DETECTION EQUIPMENT COVERED BY THIS PLAN TITLE 23 CCR § 2715(c), AND WILL PERFORM AND DOCUMENT MINIMUM MONTHLY VISUAL INSPECTIONS OF THE FACILITY'S UST SYSTEMS IN ACCORDANCE WITH TITLE 23 CCR § 2715(c). XI. OWNER/OPERATOR SIGNATURE CERTIFICATION: I certify that the information provided herein is true and accurate to the best of my knowledge. OWNER/OPERATOR SIGNATURE REPRESENTING ATE: M91. r _ [x Owner M9o. 09/27/07 Cf Operator ' OWNER/OPERATOR TITLE: ' OWNER/OPERATOR NAME (print): Daniel A Erickson Compliance Manager (Agency Use Only) This plan has been reviewed Approved Approved With Conditions E] Disapproved and: Local Agency Signature: Date: Comments/Special Conditions: hwfwrc-d (9/24/04) - 3/4