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UNDERGROUND STORAGE TANK <br /> MONITORING PLAN-PAGE 2 <br /> VI. DISPENSER MONITORING <br /> rMONITORING OF AREAS BENEATH DISPENSER(S)IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) <br /> MSu. <br /> NUOUS ELECTRONIC MONITORING OF UNDER DISPENSER CONTAINMENT(UDC) <br /> NEL MANUFACTURER: Ms1. MQDEL#: <br /> AK SENSOR MANUFACTURER: M53 MODEL#(S): M34. <br /> WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? ❑ a.YES ❑ b.NO M55. <br /> WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? <br /> ❑ a.YES ❑ b.NO MSb. <br /> WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M57. <br /> ❑ 2.MECHANICAL ASSEMBLY(e.g.,FLOAT AND CHAIN ASSEMBLY)IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK <br /> ASSEMBLY MANUFACTURER: M58. MODEL#(S): M59. <br /> ❑ 1VISUAL MONITORING DONE: ❑ a.DAILY ❑ b,WEEKLY rkequires ugmyarpmval) MFa <br /> 4.NO DISPENSERS <br /> 99.OTHER(Specify) <br /> 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 M7o. <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 /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that TRAINING <br /> 1. THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) M17A0, <br /> 2. OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) <br /> 3. THE FACILITY'S BEST MANAGEMENT PRACTICES(Required as of 1101/2005) <br /> 4. 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 INVENTORY RECONCILIATION" <br /> 7. ❑ SWRCB PUBLICATION:"WEEKLY MANUAL TANK GAUGING FOR SMALL UNDERGROUND STORAGE TANKS" <br /> 99. ElOTHER(Specify): <br /> Personnel with UST monitoring responsibilities are familiar with all of the above documents relevant to their job duties and can access those documents when needcdei <br /> By January I,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 /> A Operation of the UST systems in a manner consistent with the facility's best management practices. <br /> The facility employee's role with regard to the leak detection equipment, <br /> D 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!tired on or after January I,2005,the initial training will be conducted within 30 days of the date of hire. <br /> IX. COMMENTS/ADDITIONAL INFORMATION <br /> Please use this section to include any additional UST system monitoring-related information(e.g.,additional information required by your local a enc M85. <br /> b le Jnr s t LCCC. Get <br /> g Y): <br /> X. PERSONNEL RESPONSIBILITIES <br /> AS OF 111105,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 ACTIVITIES AND MAINTAINING LEAK DE'T'ECTION <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, OWNERIOPERATOR SIGNATURE <br /> CERTIFI ION: I certify that the' formation provided herein is true and accurate to the hest of my knowledge. <br /> OWNER/ TOR SIGNATURE REPRESENTING DATE: <br /> M91. <br /> ❑OwneC M9a, <br /> Operator <br /> 4WNE OPERATOR NAME(print): nt9z. v <br /> 1' nit <br /> OWNER/OPEIjATOR TITLE: M93. <br /> J (:r z L <br /> (Agene_e Use f7rrly) This plan has beer]reviewed and: ❑Approved ❑Approved With Conditions Disapproved <br /> ❑ <br /> Local Agency Signature: <br /> Date: <br /> Commcnts/Special Conditions: <br /> SJCE H D-d(07103)-314 -- <br /> 07123/03 <br />