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n r-1 UNDERGROU"STORAGE TANK MONITORINGPLAN — PAGE 2 VI. DISPENSER MONITORING MONITORING OF AREAS BENEATH DISPENSER(S) IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) Atso. ❑ 1. CONTINUOUS ELECTRONIC MONITORING OF UNDER DISPENSER CON TAINNIENT (UDC) PANEL MANUFACTURER:; MSt. MODEL #: LEAF: SENSOR MANUFACTURER: _ � gi Mss. MODEL #(S): ; ? Cl -2-ItDSM54. WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? [J a. 4°ES ®b. NO M55. WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? 9 a. YES ❑ b. NO Mst, WILL FAILUREIDISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? �§ °a. YES ❑ b. NO M57. ❑ 2. MECHANICAL ASSEMBLY (mg., FLOAT AND CHAIN ASSEMB1-'7 IN UDC TRIPS S * VAI VE IN CASE OF LEAK ASSEMBLY MANUFACTURER: M5a. MODEL #(S): M59. 3.VISUAL MONITORING DONE: a. DAILY ❑ b. WEEKLY (Regmm ageray Mso. ❑ 4. NO DISPENSERS ❑ 99. OTHER (Specify) hist. ND LE DT - . ON ❑ I. WE HAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT WE MUST LMPLEi1-LENT ENH,A?vCED LEAF: :.470. DETECTION (ELD) FOR THE UST(S) COVERED BY THIS PLAN. PER 23 CCR §2644.1, ELD IS PERFORMED EVERY 36\I4\TfTS AS REQUIRED . TRAINING ING REFERENCE DOCUMENTS MAINTAINED AT FACILITY (Check all that apply) Mme. I. THIS UNDERGROUND STORAGE TANK NIONITORING PLAN (Required) 2 OPERATING MANUALS FOR ELECTRONIC MONITORING EQLIIPNtENT (Required) 3. THE FACILITY'S BEST MANAGEMENT PRACTICES (Required as of 1101(.2005) 4. ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 5. ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 6. ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - M,'AN'UAL AND STATISTICAL INVENTORY RECONCILIATION" 7. ❑ SWRCB PUBLICATION: "WEEKLY MANUAL TANK GAUGING FOR SMALL UNDERGROUND STORAGE TANKS" 99. ❑ OTHER (Specify): o4s1. Personnel with UST monitoring responsibilities are familiar with all of the above documents relevant to their jab duties and can access those documents when needed. By January 1, 2005 this facility will have a Designated UST Opcmtor" who has passed the operator exam administered by the International Code. Council (ICC). By January 1, 2005, and annually thereafter, the `Designated UST Operator" trill train facility employees in the proper operation and maintenance of the UST systems. This training will include, but is not limited to, the following: > Operation of the UST systems in a manner consistent with the facility's best management practices. A The facility employee's role with regard to the leak detection equipment. > The facility employee's role with regard to spills and overfills. > Whom to contact for emergencies and leak detection alarms. For facility employees hired on or after January 1, 2005, the initial training will be conducted within 30 days of the date of hire. NTSIA. DITI N ' TI N' Please use this section to include any additional UST system monitoring -related information (mg., additional information required by your local agency): i55. ZU J`-" /— X1. X P ERESPONSMIEFMS •. AS OF 111105, THE "DESIGNATED UST OPERATOR" IDENTIFIED IN SECTION III OF THE CURRENT UST OPERATING PER -UT APPLICATION - FACILITY FORM WILL HAVE ULTIMATE AUTHORITY FOR PERFORMING THE MONITORING ACTIVITIES AND N4AINTAINI\G LEAK DETECTION EQUIPMENT COVERED BY THIS PLAN, AND WILL PERFORM AND DOCUMENT MINIMUM MONTHLY VISUAL INSPECTIONS OF "TETE FACILITY'S UST SYSTEMS IN ACCORDANCE WITH 23 CCR § 2715(b). SIGNATURE CERTIFICATION: I certify that the information provided herein is true and accurate to the best of m`• know•led e. OWNERIOPE TORSI NA REPREaENTING ❑Owner M90. DATE: eta1. / ^ -gyp Z 2-0 ®,� rator OWNERIOP TOR NAME (print): M,' OWNERIOPERATOR TITLE: rtss. Id l� �4off (Agency Use Only) This plan has been revi and: Approved ❑ Approved With Conditions Disapproved Local Agency Signature: Dste: Comments/Special Conditions: SX -EH r -a `ornrs) - N4 07/23103