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Underground Storage Tank'Monitorioan—Page 2 of 2 • VT. DISPENSER MONITORING MONITORING OF AREAS BENEATH DISPEN$ER(S)IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) MSO. ® 1.CONTINUOUS ELECTRONIC MONITORING OF UNDER DISPENSER CONTAINMENT(LIOC) PANEL MANUFACTURER:VeaderROOt Mst' MODEL#:350 M3^ LEAK SENSOR MANUFACTURER:VeedeClRo)t M03' MODEL#(S)•794350-20a M$4. WILL DETECTION OF A LEAK INTO Tlall!UDC TRIGGER AUDIBLE AND VISUAL ALARMS? ® a YES ❑ b,NO Mss, WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? ® a.YES ❑ b.NO M" WILL FAILURFJDISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ® a.YES ❑ b.NO Mrs ❑ 2.MECHANICAL ASSEMBLY(e.g.,FLOAT AND CHAIN ASSEMBLY)IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK ASSEMBLYMANUFACTURER MSI' MODEL#(S): M59 ❑ 3NISUALMONTTORINGDONE: ❑ a.DAILY ❑ b.WEEKLY(Rr4eiratnµteyep--o M60. ❑ 4,NO DISPENSERS ❑ 99.OTHER(Specify) Wt. VII. ENHANCED LEAK DETECTION ❑ 1.WE HAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT WE MUST IMPLEMENT ENHANCED LEAK Mm DETECTION(BID)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 apply) Mao, I. 0 THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 2. ® OPERATING MANUALS FOR ELECTRONIC MONTTORING EQUIPMENT(Required) 3. ❑ 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: 'ILkNDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL DTVBN70RY RECONCILIATION" 7, ❑ SWRCB PUBLICATION:-WEEKLY MANUAL TANK GAUGING FOR SMALL UNDERGROUND STORAGE TANKS" 99.0 OTfiER(Specify): Mel, Personnel with UST monitoring rcapnncibilitics are familiar with all of the above documents relevant to diairjob duties and can access these documents when needed. By January 1,2005,this facility will have a"Designated UST Operator"who bas 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"stems.This training will include,but is not limited to,the following: D Operation of the UST systems in a manner consistent with the facility's best management practices. The facility employee's role with regard to the leak detection equipment Y The facility employee's role with regard to spins and overfins, ➢ Whom to contact for emergencies and leak detection alarms. For facility employers hired on or after July 1,2005,the initial training will be conducted within 30 days of the date of hire. IX. COMMENTS/ADDITIONAL INFORMATION Phase user this vection to include any additional UST system monitoring-related information(erg.,additional information required by your local agency): utas. Note regarding Section X.Pending certincation of a Designated UST Operator,the folkyMng person has authority for performing the monitoring actIvities and maintaining leak detection equipment covered by this plan. NAME:Michelle Le JOB TITLE:Envr Specialist Overfill prevention system is a mechnical flapper set at 95%, X. PERSONNEL RESPONSIBILI'T'IES AS OF JANUARY I, 2005, THE "DESIGNATED UST OPERATOR" IDENTIFIED IN SECTION IB OF THE CURRENT UST OPERATING PERMrr APPLICATION—FACILITY FORM WILL HAVE ULTIMATE AUTHORITY FOR PERFORMING THE MONITORING ACnvrFms AND MAINTAINING LEAK DETECTION EQUIPMENT COVERED BY THIS PLAN,AND WILL PERFORM AND DOCUMENT MINIMUM MONTHLY VISUAL INSPECTIONS OF THE FACILITY'S UST SYSTEMS IN ACCORDANCE WITH 23 CCR 12715 . XI. OWNER/OPERATOR SIGNATURE CERTIFICATTONt I certify that the information Rrovided herein is true and accurate to the hest of my knowledge, O /OPERATORr NA R9EEF,k [Mq DATE: �t 0 Owner ALSO ❑operator December 4, 2007 OWNER/OPERATOR NAME(p ' ): M9z' OWNER/OPERATOR TITLE: Mss' Michelle Le Environmental Specialist (Agency Use Only) This plan has bem Taut and: X71pproved ❑Appmvcd With Conditions /❑Disapproved Local Agency Signature: Dare: rYI Q Cornmwts/Special Conditions: tTN422A•3/S www.unidoes.org Rev.10/14/03