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a <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) M50. <br /> ® 1.CONTINUOUS ELECTRONIC MONITORING OF UNDER DISPENSER CONTAINMENT(UDC) <br /> PANEL MANUFACTURER: ][;AT M51_ MODEL 4: M52. <br /> LEAK SENSOR MANUFACTURER: rt�ri MS3. MODEL##(S): Msa. <br /> V1 <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? ❑ a.YES [54 b.NO M56. <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: Mss' MODEL NS): Mss' <br /> ❑ 3.VISUAL MONITORING DONE: 09 a.DAILY ❑ b.WEEKLY(Requires agency apprmal) M60. <br /> ❑ 4.NO DISPENSERS <br /> [ <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 M70 <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. Z 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. 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 /> Mai. <br /> 99.❑ OTHER(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 needed. <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 o£the UST systems. <br /> This training will include,but is not limited to,the following: <br /> Y Operation ofthe UST systems in a mariner consistent with the facility's best management practices. <br /> q The facility employee's role with regard to the leak detection equipment. <br /> 3• 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/ADDITIONAL INFORMATION <br /> Please use this section to include any additional UST system monitoring-related information(e.g.,additional information required by your local agency): Mss. <br /> X. PERSONNEL RESPONSIBILITIES <br /> AS OF I/l/05,THE"DESIGNATED UST OPERATOR" IDENTIFIED IN SECTION 111 OF THE CURRENT UST OPERATING PERMIT APPLICATION — <br /> FACILITY FORM WILL HAVE ULTIMATE AUTHORITY FOR PERFORMING THE MONITORING ACTIVITIES 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 GCA '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 /> OWqlMTOR SIGNATURE REPRESENTING DATE. <br /> A Owner M9o. <br /> El operator <br /> OWNER/OPERATO NAME(print): M92. OWNER/OPERATOR TITLE: M" <br /> (Agemy Use Only) This plan has been reviewed and: ❑Approved ❑Approved With Conditions ❑Disapproved <br /> Local Agency Signature: Date: <br /> Comments/Special Conditions: <br /> 07/23/03 <br /> SJCEHD-d(07103)-3/4 <br />