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UNDERGROUND STORAGE TANK -MONITORING PLAN PAGE 2 V1.DISPENSER MONITOVING MONITORING OF AREAS BENEATH DISPENSF.P.(S)IS PERFORMED USING THE FOLLOWING AIETHOD(S)(Check all that apply) 1rn ❑ I.CUN'1'INC!OUS LI,ECTKt-SIC R•IONl'1'ORIN'�:Oh UA`1}IiR DISPL--/\,�SI�:,R CONTAINVthN'f(TIDO PANEL MANUFACTURER: �- 1,[J�' ntst. MODEL#: LEAK SENSOR MANUFACTURER: V D F 14x3. NIODEL#(S): WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? a.YES ❑ b.NO A155. WILL A UDC LEAK ALARM TRIGGER AUT'OhIATIC PUMP SHUTDOWN? � a.YES ❑ b.NO 1416. WILL FAILUREIDISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? a.YES ❑ b.NO �tsr• ❑ 2.MECHANICAL ASSE LY(e.g.,FLOAT X D CHAIN ASSEMBLY)IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK ASSEMBLY MANUFACTURER: mss$ A•IODEL#(S): 109. 3.VISUAL MONITORING DONE: W as DAILY ❑ b.WEEKLY(Requires agencyapprowd) 1960. ❑ 4.NO DISPENSERS ❑ 99-OTHER(Specify) 1461. Ir- ENHANCED LE C ❑ 1.tVE HAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT UTE MUST MPLE.\LENT ENHANCED LEAK M70- DETECTION(ELD)FOR THE UST(S)CON,ERED BY THIS PLAN.PER 23 CCR§2644.1,ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED TRAINING 1 RI IT_Rl1 Nc Ii DOCI h1ENTS IMAINTAiNED AT FACILITY(Check all that apply) Mso. 1. ( 'I'IIIS UNDERGROUND STORAGE TANK`TONT MING PLAN(Required) 2. OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) 3. 9 IT IE FACILITY"S BEST\fANAGEt1IENT PRACTICES(Required as of 10012005) 4. ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIO\S 5. ❑ CALIFORNL1 UNDERGROUND STORAGE TANK LAW 6. ❑ STATE WATER RL-'SOURCE.S CONTROL. BOARD (SWRC.B) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND S'TA"TIST'ICAI.INVENTORY RECONCII.I:iTION" 7. ❑ SWRCB PUBLICATION:"M-EKLY AI.-1NUAJ<TANK GAUGING FOR S\-TALL UaNDERGROUND STORAGE TANKS" 99. ❑ OTIIER(Specify): Personnel wills LUST monitoring responsibflhtics are familiar with all of the abode documents relevant to their job duties and can access those documents schen needed. By January 1,2005 this facility will have a"Designated UST Operator"who has passed die operator exam administered by the International Code Council(ICC). By January 1,2005,and annually thereafler,the "Designated UST Operator"will train facility employees in the proper operation and maintenance of the UST systems. Tins training will include.but is not limited to,the following: r 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. i The facility employee's role with regard to spills and overfills. o Whom to contact for emergencies and leak detection alarms. For facility employees hired on or after January I,2005,the initial training will be conducted within 30 days of the date of hire- IX. COMMENTS/ADDITIONAL i ATION Please use this suction to include ane-additional UST system monitoring-related information(e.g.,additional information required by your local agency): X. PERSONNEL RESPONSIBILITIES AS OF 1/1/05,THE "DESIGNATED UST OPERATOR"IDENTIFIED IN SECTION III OF THE CURRENT UST OPERATING PERMIT APPLICATION FACILITY FORs-4 WILL HAVE UL'I'INIATE AUTHORI'T'Y FOR PERFOR.®IING THE MONITORING ACTIVITIES.XtD AL-INTAINI NG LEAK DETECTION EQUIPNIEN'T COVERED BY THIS PLAN,AND WILL PERFORM AND DOCUINIENT MINIMUM MONTHLY VISUAL INSPECTIONS OF THE FACILITY'S LIST SYSTEMS IN ACCORDANCE W111-123 CCR§2715(b). SIGNATUREX1. OWNER/OPERATOR CERTIFICATION: I certif`•that the information provided berein is true and accurate to the best of Div knowledge. OWNER/OPE TOR SI�:ATL E REPRESENTING DATE: f p 1494. [I Owner 1190. Z--? *'7 �e� 10, ( GC! '2/ OWNER/OPERATOR NA.KIE(print): M92. OWNIER/OP ATOR TITLE: as93- X14 , ("Agenc),Use Only) Th�hasbccnd and: Approved ❑Approved With Conditions Disapproved Local Agency Signature: Date: Comments/Special Conditions: SJC EHD-d(07/03)-3/4 07f23/03