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06/29/05 WED 10: 02 FAX 209 BJS 6909 COUNTRY-MARKETPLACE -we <br /> U udelground Storage Task Monitoring Plan-Page 2 of 2 <br /> MONITORINGOF AREAS BE),WATH DTSPFNSLR(S)19 PERFORMED USINGTHL FOLLOW4NGMETII01)(5)(Check all thatopply) Y �Tii <br /> r L CONTINUOUS ELECTRONIC MONI'TOFUNG OP UNDER DISPENSER CONTAINMENT(LTDC) <br /> PANF.I,MANUFACTURLIL Jj/L S✓#-&f9:1 Ulf MOUL'La: /rPs 5 Mfi <br /> LEAK SENSOR MANUFACTURER. ((L Zt-o Mn. MOTITLI(S): 7AP- OA, Mil <br /> WILL DETECTION OF A LEAK INTO THE UDC)RIGGER AUDIBLE AND VISUAL ALARMS? Is a.YES ❑ b.NO MJa. <br /> WILL A UDC LEAK ALARM TRJOGTRAUTOMATIC PUMP SHUTDOWN? ■ - YES ❑ b.N0 Mid <br /> Will.FAILUREIDISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? 0 a,YES ❑ b.NO MsO. <br /> ❑ 2.MFCFIANICAL ASSEMBLY(e,g.,FLOAT AND CHAIN ASSEMBLY)IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK <br /> ASSEMBLY MANUFACTURER. M)t. MODEL NIS)• _ Must <br /> ❑ 3.VISUAI.MONI'1'OKRNG DONE: ❑ a.DAILY ❑ b.WEEKLY meydr.cap y.rrr.a) Mia <br /> ❑ CNODISPENSERS <br /> ❑ 99.OTHER(Speeiry) hst. <br /> YT:':ENAANi; LEARDETECTIO <br /> ❑ 1.WE HAVE OlihW NOTIFIED BY THE STATE WATL'R RESOURCES CONTROL BOARD THAT WE MUST 1MPLEMBNT FNHANCED LLAK ki <br /> DETECTION(L'LDI FOR THE USTIS)COVERED BY THIS PLAN.PER 2)CCF 92644.1,ELD IS PERPORMEn EVERY 36 MONTHS AS REQUIRED <br /> TRAINING <br /> RF3ERENCE DOCUMEMI S MAINTAINED AT FACILITY(Check JI that apply) MN. <br /> 1. TRIS UNDFROROUND STORAGE TANK MONITORING PLAN(ReArVOW) <br /> 2. OPERATINO MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Regotred) <br /> 3. THE FACILITY'S RESI'MANAGE•MENT PRACfICES(Baldness As ofdanuary 1,3003) <br /> 4. ❑ ,CALIFORNIA UNDERGROUND STORAGE TANK REGVLAr1ONS <br /> S. ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW <br /> e. STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS • MANUAL. AND <br /> STATISTICAL INVENTORY RECONCILIATION" <br /> T. ❑ SWRCB PUBLICAI'ION:"WEEKLY MANUAL TANK GADDING FOR SMALL UNDERGROUND STORAGE TANKS' <br /> 99.❑ OTHL'R(Speeify)', - vial. <br /> Penankel widt USImonaoring respunslb,illles are familiar williall of the above dMumeets relevant to their job dsRier,and can sievuht those documents sMgn needed <br /> By Jnmlury 1,2005,this facility will have a"Designated UST Operator-Who his Passed Jho Cdireroia UST Sykm Operator P.Raln ddmin,ncred by the Iratmutionsl <br /> Code Council(ICC). By July 1,2005,and onuwily rhoeatle,,the `Deslgnaled U5T Operator"will train facility empluyees in the proper uperarlon and maintenance <br /> ofthe UST syl4mt.This Irxinln6 will hldndc,hos is not limited le,the following: <br /> OpciAlion of the UST systems in a manner tonsisitnl with the facility's'oat managemnll practices. <br /> Y The fiedilyempluy,a's role with regard 10 the kik tklacdan cquipmcnl. <br /> Y The nellhy emplayec's role•nth regard to spilb and Overfills. <br /> D Whom to contact furemeranwiee and Ink datectie r, 1. <br /> For facility crnployc4 hired on or ones July 1,2003,the initial Ksining will be conducted within 30 days orthe dem ofhire. <br /> IX, COMMENTS/ADDITIONAL INFOlIMATION. .. <br /> Flew Use this accdno ro Include ony additional UST system nsatilpr,nt-relMsd intor m in.it g.,oddidasul in ormmktn required M your Ions agency): Hat. <br /> Note regarding Section R.Pending catrtificaGon of a Designated UST Operator.Iha fallowing parson has authority for performing the monitoring <br /> aCliyihes and maintaining look detection agUlpmlent covered by this plan. NAME: JOB TITLE: <br /> X. PERSONNEL RESPONSIBILITIES <br /> AS OR JANUARY I, 7005, THE "DESIGNATED USI' OPEM'fUR" IDENTIFIED M <br /> SECTION BI OF THE CMLE UST OYEMTINO PERMIT <br /> APPLICATION–FACILITY FORM WILL HAYS ULTIMATE.AUYHORITY FOR PF-RFOKMING TILE MONITORTNO ACTIVITIES AND MADnAININO <br /> LEAK DErECT10N MUIPMEN'1'COVERED BY THIS PLAN,AND Wft.1.PERFORM AND DOCUMENT MINIMUM MONTHLY VISUAL INSPECTIONS <br /> OF THE FACILITY' UST SYSTEMS IN ACCORDANCE WITH 23 CCR i 2715(bJ <br /> XI. OWNERIOPERATOR SYGNATIJRE <br /> CERTIFICATION:I certify shat the Inibrmatian provided herein Is true and atestntc to the Lestofmv Imowlcvlaa <br /> OWNERJOT'EM'rORS10NATURE DAI'h: M°I <br /> D.mtr sae c��2dl�s <br /> ____Jj3 Operatnr <br /> OWNLRIOPERATOR NAME(p(int) — cls' ON'N I:MPF.RATOR <br /> >7� G <br /> RftlGil ) nc��f»/ <br /> (Agency We Only)I This plan Ilnv been reviewed aid: ❑Approved 0 Approved With Conditions ❑Daupproved <br /> Loral Agerky Signotore; __ Dalai <br /> CommenwSpeebl Conditions: .. .. — <br /> UN-072A-3/3 vr.vw.naidocv.era )irv.10/Ia103 <br /> E d OOZE 13CM3SUI dH WdBb :21 0002 82 Nf1C <br />