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Ah <br />Ah <br />UNDERGROUND STORAGE TANK <br />MONITORING PLAN - PAGE 2 <br />VI. DISPENSER MONITORING <br />MONITORING OF AREAS BENEATH DISPENSER(S) IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) Myo. <br />® 1. CONTINUOUS ELECTRONIC MONITORING OF UNDER DISPENSER CONTAINMENT (UDC) <br />PANEL MANUFACTURER: t-I)Y� Ms1. MODEL4: Mst. <br />� <br />LEAK SENSOR MANUFACTURER: --r"L ]ri W3. MODEL #(S): Ms4. <br />WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? ® a. YES ❑ b. NO Mss. <br />WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a. YES 13 b. NO M56 <br />WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a. YES Q§ b. NO M59. <br />❑ 2. MECHANICAL ASSEMBLY (e.g., FLOAT AND CHAIN ASSEMBLY) IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK <br />ASSEMBLY MANUFACTURER: MS8 MODEL #(S): W9. <br />❑ 3.VISUAL MONITORING DONE: 14 a. DAILY ❑ b. WEEKLY (RNvir .ae �.Id) M6. <br />❑ 4. NO DISPENSERS <br />❑ 99. OTHER (Specify) M61, <br />VII. ENHANCED LEAK DETECTION <br />❑ 1. WE HAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT WE MUST IMPLEMENT ENHANCED LEAK Mr0' <br />DETECTION (ELD) FOR THE UST(S) COVERED BY THIS PLAN. PER 23 CCR $2644.1, ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED <br />VIII. TRAINING <br />REFERENCE DOCUMENTS MAINTAINED AT FACILITY (Check all that apply) M80. <br />1. ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN (Required) <br />2. ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT (Required) <br />3. ® THE FACILITY'S BEST MANAGEMENT PRACTICES (Required as of 1/01/2005) <br />4. [ig CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS <br />5. ® CALIFORNIA UNDERGROUND STORAGE TANK LAW <br />6. ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND <br />STATISTICAL INVEN'T'ORY RECONCILIATION' <br />7. ❑ SWRCB PUBLICATION: "WEEKLY MANUAL TANK GAUGING FOR SMALL UNDERGROUND STORAGE TANKS" <br />99. ❑ OTHER (Specify): <br />Personnel with UST monitoring responsibilities are familiar with all of the above documents relevant to theirjob duties and can access those documents when needed. <br />By January 1, 2005 this facility will have a "Designated UST Operator" who has passed the operator exam administered by the International Code Council (ICC). By <br />January 1, 2005, and annually thereafter, the "Designated UST Operator" will train facility employees in the proper operation and maintenance of the UST systems. <br />This training will include, but is not limited to, the following: <br />Y Operation of the UST systems in a mamer consistent with the facility's best management practices. <br />➢ The facility employee's role with regard to the leak detection equipment. <br />➢ The facility employee's role with regard to spills and overfills. ' <br />➢ Whom to contact for emergencies and leak detection alarms. <br />For facility employees hired on or after January 1, 2005, the initial training will be conducted within 30 days of the date of hire. <br />IX. COMMENTS/ADDPITONAL INFORMATION <br />Please use this section to include any additional UST system monitoring -related information (e.g., additional information required by your local agency): M85. <br />v.ae-�-o ylevevj <br />J <br />o D n <br />X. PERSONNEL RESPONSIBILTTIES <br />AS OF 1/1105, THE "DESIGNATED UST OPERATOR" IDENTIFIED IN SECTION III OF THE CURRENT UST OPERATING PERMIT APPLICATION — <br />FACILITY FORM WILL HAVE ULTIMATE AUTHORITY FOR PERFORMING THE MONITORING AC'T'IVI'T'IES AND MAINTAINING LEAK DETECTION <br />EQUIPMENT COVERED BY THIS PLAN, AND WILL PERFORM AND DOCUMENT MINIMUM MONTHLY VISUAL INSPECTIONS OF THE FACILITY'S <br />UST SYSTEMS IN ACCORDANCE WITH 23 CCR § 2715(b). <br />XI. OWNER/OPERATOR SIGNATURE <br />CERTIFICATION: I certify that the information provided herein is true and accurate to the best of my knowledge. <br />OJR/OPIHARATOR SIGNAIDRE REPRESENTING <br />DATE: Mgt. <br />LN o Opertor wner M9a. <br />OWNER/OPERAT NAME(print): 1r°z <br />OWNER/OPERATORTITLE: M9s. <br />(Agency Use Only) This plan has been reviewed and: ❑ Approved ❑ Approved With Conditions ❑ Disapproved <br />Local Agency Signature: Date: <br />Comments/Special Conditions: <br />SJCEHD-d (07/03) - 3/4 0712NO3 <br />