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UNDERGROUND STORAGE TANK <br /> MONITORING PLAN-PAGE Z <br /> r <br /> rrYIt ?XSPNSR M4N � NG z x T '� <br /> MONITORING OF AREAS BENEATH DISPENSER(S)IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) n M50. <br /> ❑ 1.CONTINUOUS ELECTRONIC MONITnR•ING OF UNDER DISPENSER CONTAINMENT(UDC) <br /> PANEL MANUFACTURER. - M51 MODEL#: 7 9 43q, D-^Z 0 S M52. <br /> LEAK SENSOR MANUFACTURER: V E E D+.(Z R O Or "" MODEL#(S): -TL 3.50 M54. <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 ❑ b.NO Ms6. <br /> WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? a.YES ❑ b.NO MIT <br /> ❑ 2.MECHANICAL ASSEMBLY(e.g.,FLOAT AND CHAIN ASSEMBLY)IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK <br /> ASSEMBLY MANUFACTURER: M"- MODEL#(S): M59. <br /> ❑ 3.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(Requires agency appmv l) Mho. <br /> ❑ 4.NO DISPENSERS <br /> ❑ 99.OTHER(Specify) M61. <br /> _ t. t', I NHANGED E DE I.3C2'�4 Y .� �� _ <br /> r <br /> _ . z_ _ _. <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.I,ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED <br /> '50.NOWI WON', x^ <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) Mao. <br /> L-125, 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 /> 99. ❑ OTHER(Specify): Mat. <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 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 I,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 /> ➢ Operation of the UST systems in a manner consistent with the facility's best management practices. <br /> D 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 /> ��"�� ,x'� 4 'M;rx . �����:IMENTS/ADD��'��1��.�•7`�NFORl1%��i.�`I���1 �, �.�n��r � � �; x <br /> Please use this section to include any additional UST system monitoring-related information(e.g.,additional information required by your local agency): Me5. <br /> Avis, ,t1L Puy"? SHv? tSFF LAJ1LJL ocI-uLE WHEntb-vz� ; <br /> (,F_LEASE IS SENSED 114 TUL81►JE SurnQ <br /> (LE LeASr- 15 $ENCED aC Q1S�E►JSEti- <br /> Mtp4 To(Ll1\R. l-fVE^^ l5 1)1500NNFC-'YE0 O(L FA,1" IN RNV WAY ( FAtL-SAFE) <br /> X,.4 ,ERSOIVNEL2ESPOMT$ILITIES.'-'_ � _.._ :¢ _. _. •. ',. <br /> AS OF I/I/05, 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 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/OPERATORA$IGNATURE <br /> CERTIFICATION: I certify that the information provided herein is true and accurate to the best of my knowledge. <br /> OWNER/OPERATOR <br /> vTURE REPRESENTING DATE: Mgt. <br /> ❑Owner M9o. <br /> ❑Operator v <br /> OWNER/OPERATOR NAME(print: M92. OWNER/OPERATOR TITLE. M93. <br /> 1LUL DSS—9 C • S1ImLmN 'MEMgp-(ZI OwNEll OF LL c <br /> (Agency Use Only)— This plan has been reviewed and: ❑Approved ❑Approved With Conditions ❑-Disipproved <br /> w Local Agency Signature: Date: <br /> Comments/Special Conditions: <br /> SJCEHD-d(07/03)-3/4 07/23/03 <br />