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AUG-21-2008 02:07 FROM:SCKAASF 209-983-5394 70:2094683433 PAGE:01 0 - - 0 UST Monitoring Plan--Page 2 Instructions compicic a sepurute tJS•r Monitoring Plan lm each UST manitoring system at the facility, This form must be submitted with your initial UST Operating Permit Application and within 30 days of changes in the information it contains. please note that ytnir local of en-.y may require you to obtain approval nria,r to insialfing or modit'ying monitoring equipment. (Note: Numbering of these instructions follows the d4.ta element numbers on the form.) M50. DISPhNSIilt MONITORING MCTHOD(S)-Check the appropriate box(cs)in Section IV to identify all required methods used fur monitoring the iln:a(s)hcnealh the di%peliser(s). If no dispensers are installed(e.g.,USTs supplying standby generators),cheek item VI-5. M51. PANEL MANUFAC"I'tJRlitt -If item VI-I is checked,enter lite name ofthe manufacturer of the rnonituring system(ontrof panel(console). II'tllere is tic)control panel(e.b.,only an electrical relay box is installed)leave this space blank. M52. MOi)I:I,It If hent VI-I Is checked,enter the model number For the monitoring System C+omnol panel, If(here is no cururol pallet(e.g.,only an electrical relay hux is installed)leave this space blank. M53, I.I:AK SENSOR MANUFACTURER-If ilem Vl-I is checked,enter the name nt'the matluf'aCturer of the scnsor(s). M54. MODE:L.N(5)-I f item V1-I is checked,enter the model num her for each type of sensor installed.I f additional space is t y:cdcd,use Section IX. MSS. WILL DrTcCTION OF A I.t?AK INTO UDC TRIGGER AUDIAI,F AND VISUAL ALARMS?-If item VI-I is checked,check Yes or No. M56, WILL A I 0C 1.1':AK AL.ARM'I IMUC ER.PUMP SHUTDOWN'?•-If item VI-I is checked,check Yes or No. M57. Will.FAILLIItti?DISCONNI?C,'rION OI'UDC MONITORING TRIGGER SI IUTD0WN7-If item VI-1 is checked,check Yes or No, MSK, ASST:M111.Y MAN IIFAC RfRh'It-If item VI-2 is checked,enlcr the name of the manufacturer of the mechanical Irak detection assembly. M59. M()I)I•'I.#(S)-If item VI-2 is checked,enter the model number for each type of mechanical leak detection assembly installed. if additional Space is needed,use Section IX. Mbn. VISUAL MONI'TOItING OONE -if iters VI-3 is checked,check the appropriate box to describe the frequency of visual monitoring. MRI. SPECIFY If•item VI-99 is checked,enter a brief description of the other method(%)used to moltltor the UDC. If addillonal space is needed, use Section IX. M70. IiNI IANC HD LEAK DETECTION —C:hcck the box if you have been notified by the State Water Resources Contrul ®.card(SWRC13)that the IJST(s)covered by [his plait Ware subject to Enhanced Leak Detection Requirements(i.e.,UST has any single-wall component and is located %vithin 1,41011 feel of a public drinking water well). MKI. RHFERENCE' DOC UMFN I'S MAINTAINED AT FACILITY—Check the appropriate boxes to describe reference dw.unients maintained at the 1 aciliiy. Note that items I,2,and 3 mug he kept at the facility. M81. SPI-;C:IFY — it*item VIII-99 is checked,enter a brief description of the other document(s) maintained at the facility if additional space is needed,use Section IX, M95. COMMRNTS/ADDITIONAL INFORMATION — You may use this section to describe any additional UST sys:cm monitoring-related infonilmlon(r.g.,additional information required by your local agency'). If using Section IX as additional space for it.:ms required elsewhere in this plan,rclercnce the item number(e.g.,"Item M54-Model 2468 and 3579 beak Sensors"). oWN131t/Ol'i;'RATOR SIONA'I URF:—The ownerhtperatur shall sigh in the space provided. This signature certifies that the signer believes that all inl'in,nation submitted is true,accurate,and complete.and that the training program specified in Section VIII ha,been implemented.. M90. Rl'11R iSENTING •Check the appropriate box to indicatc whether the Signer is representing the IJST owner or HST op.rauir. M91, DATF-Enter the elate the plan was signed. Mq2. OWNFRA)VERATOli NAME`-Print or type the name of the person signing the plan. M93. OWNER/Ol"ERATOR TITLE-Enter the title of the person signing the plan. `a•IC'EIli!-4I(1171113).414 0717,.111.3