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Underground Storage Tank Monitoring n—Page 2 of 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: M51. MODEL#: M52. <br /> LEAK SENSOR MANUFACTURER: M53. MODEL#(S): 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 M56. <br /> WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP S ? ❑ a.YES ❑ b.NO M5z <br /> ® 2.MECHANICAL ASSEMBLY(e.g.,FLOAT AND CHAIN ASSEMBLY)IN UDC TRIPS SHEAR VALVE IN CASE LEAK <br /> ASSEMBLY MANUFACTURER:MLD M58. MODEL#(S .FX1 DV M59. <br /> ❑ 3.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(Requires agency approval) M60. <br /> ❑ 4.NO DISPENSERS <br /> ❑ 99.OTHER(Specify) M61. <br /> VII. ENHANCED LEAK DETECTI <br /> ❑ 1.WE HAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT MUST IMPLEMENT ENHANCED LEAK M70. <br /> DETECTION(ELD)FOR THE UST(S)COVERED BY THIS PLAN.PER 23 CCR§2644.1,ELD PERFORMED EVERY 36 MONTHS AS REQUIRED <br /> VIII. TRAINING <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that appl/MALL <br /> Mao. <br /> I. ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Re <br /> 2. ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIP <br /> 3. ® THE FACILITY'S BEST MANAGEMENT PRACTICES(Required as ) <br /> 4. ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS <br /> 5. ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW <br /> 6. ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBDBOOK FOR TANK OWNERS - MANUAL AND <br /> STATISTICAL INVENTORY RECONCILIATION" <br /> 7. ❑ SWRC13 PUBLICATION:"WEEKLY MANUAL TANK GAUGING FORGROUND STORAGE TANKS" <br /> M81. <br /> 99. ❑ OTHER(Specify): <br /> Personnel with UST monitoring responsibilities are familiar wi/fac*ity's <br /> e abov 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 "wh as passed the California UST Sytem Operator Exam administered by the International <br /> Code Council(ICC). By July 1,2005,and annually thereafter, si ted UST Operator"will train facility employees in the proper operation and maintenance <br /> of the UST systems.This training will include,but is not limitefo wing: <br /> ➢ Operation of the UST systems in a manner consistent wi 'ity's best management practices. <br /> ➢ The facility employee's role with regard to the leak detecipment.➢ The facility employee's role with regard to spills and ove➢ Whom to contact for emergencies and leak detection alarFor facility employees hired on or after July 1,2005,the initialwill be conducted within 30 days of the date of hire. <br /> IX, COM NTS/ADDITIONAL INFORMATION <br /> Please use this section to include any additional UST systemonitoring-related information(e.g.,additional information required by your local agency): Mss. <br /> Note regarding Section X. Pending certification of a esignated UST Operator,the following person has authority for performing the monitoring <br /> activities and maintaining leak detection equipme covered by this plan. NAME:KAREN ARNAIZ JOB TITLE:DESIGNATED <br /> OPERATOR <br /> X. PERSONNEL RESPONSIBILITIES <br /> AS OF JANUARY 1, 2005, THE " ESIGNATED UST OPERATOR" IDENTIFIED IN SECTION III OF THE CURRENT UST OPERATING PERMIT <br /> APPLICATION—FACILITY FO WILL HAVE ULTIMATE AUTHORITY FOR PERFORMING THE MONITORING ACTIVITIES AND MAINTAINING <br /> LEAK DETECTION EQUIPMEN,1 COVERED BY THIS PLAN,AND WILL PERFORM AND DOCUMENT MINIMUM MONTHLY VISUAL INSPECTIONS <br /> OF THE FACILITY'S UST SYS MS IN ACCORDANCE WITH 23 CCR§2715(b). <br /> XI. OWNER/OPERATOR SIGNATURE <br /> CERTIFICA ON:I c tify that the information provided herein is true and accurate to the best of my knowledge. <br /> OWNER/OPE ATURE REPRESENTING DATE: M91. <br /> ®Owner M9o. <br /> ❑Operator Aril 16, 2007 <br /> OWNER/OPE R NAME(print): M92. OWNER/OPERATOR TITLE: M93. <br /> ROHDA HE RY CUSTOMER SERVICE COORDINATOR <br /> (Agency Use nly) This plan has been reviewed and: ❑Approved ❑Approved With Conditions ❑Disapproved <br /> Local Agenc ignature: Date: _ <br /> Comments/Special Conditions: <br /> UN-022A-3/5 www.uiiidocs.org Rev.10/14/03 <br />