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09/26/2003 10:17 2094683 FIFTH FLOOR PAGE 03 , UNDERGROUND STORAGE TANK MONITORING PLAN—PAGE 2 .;i>: 'YI:AISPENSE 'MONIT R %. - ;.�• MONITOR,NG OF AREAS BENEATH D7SPENSER(S)L5 PERFORMED USING THE FOLLOWING MMOD(S)(Check atI that apply) �tsa ❑ 1.CONTINUOUS ELECTRONIC MONTMRING Of UNDER DISPENSER CONTAINMENT(UDC) PANEL MANUFACTURER: rttsl. MODEL;.: LEAK SENSOR MANUFACTURER: MODEL#(S): itss WELL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO mss' WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SH , 11a YES C1 b,NO � IJ 12 ( 8� ,MECHANICAL ASSEMBLY e. FLOAT CFIA ASSEMBLY)1N UDC TRIPS SHEAR YALvE IN CASEU�E ❑ a YES E3 b,NO Mn ASSEMBLY MANUFACTURER: M5'- MODEL#(S): nils. [fid 3•V LSUAL MONITORING DONE: ❑ a DAILY 21b.WEEXLY`(a_q ,a&.q V7,,,A � ❑ 4.NO DISPENSERS ❑ 99.OTHER(Specify) [] 1.WE HAVE BEEN NOTIFIED BY THE STATE WATER MSOURCES CONTROL BOARD THAT WE MUST 24PL>:h1ENT ENHANCED LEAK srta ETECDON(ELD)FOR THE UST(S)COVERED BY THIS PLAN,PER 23 CCR¢2644,I,ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED YING ` REFE CE DOCUMENTS MAIN'T'AINED AT FACILITY(Check all that apply) 1. HIS UNDERGROUND STORAGE TANKMONITORING PLAN(Required) 2. 0PERATNG MANUALS FOR ELECTRONIC MONITORING EQUWME-'4T(Required) 3- FACILITY'S BEST MANAGEMENT PRACTICES(IRequ!red as of wj/20o4) 4. AFL,X RNIA UNDERGROUND STORAGE TANK REGULATIONS 5. CALTORN A UNDERGROUND STORAGE TANK LAW 6. ❑ STATE WATER RT:SDURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION" 7. ❑ SWRCB PUBLICATION:"WEEKLY MANUAL TANK GAUGING FOR SMALL UNDERGROUND STORAGE TANKS" 99.❑ OTHER(Specify): nest. Personnel with UST monitoring responsibilities are familiar with all of the above documents relevant to their}ob duties and can access those documents when needed. By July [,2004,this facility will have a"Deaignared UST Operator"who has passed the operator exam administered by the Int eMal,ionat Code Council(TCC). Ely July 1,2004, and arutually thereafter,the "Designated UST Operator" will 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. > 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 Ieak detection alums. For facility employees hired on or atter July 1_2004,the initial training will be conducted within 30 days of the date of hire. IX:: COM ffNTSIADDITION.AL INFORMATION . Please use this section to include nay addidortat UST system monitoring-related information(e.g.,additional irdbrmation rcqui td by your local agencutas. y}: D . ... .AS Or ,THE DESIGNATED UST O UN1�L' S.�"ONS1B�; YE ''`". ., '--:_:::�= :...,,.,,,. :. ..,,..;:<•.. OPERATOR"IDENTIFIED IN SECTION 111 OF THE CURRENT UST OPERATING PERMIT APPLICATION— FAC'ILTfY FORM WILL HAVE ULTIMATE AUTHORITY FOR PERFORMING THE MONITORING ACTIVITIES AND MAINTAiP1NG LEAK DETECTION EQUIPMENT COVERED fly 1-1-IS PLAN,AND WILL PERFORM AND DOCUMENI-MINIMUM MONTI Y VISUAL INSPECTIONS OF THE FACILITY'S UST SYSTEMS IN ACCORDANCE WITH 23 CCR 2715(b). XY: :OWfiROPETQt SSG T cERTICfy at the ifoFIATION. rmation _. provided bereiri is true and accurate to the best of my knowledge- OWNER/OPERA/7 A REERBa5h=ig DATE: Per. ❑Owner MW. ❑Operator �0 �5 OWNER(OPERATOR AME(print) OWNEPERATOR TITLE (4gei cy We Only) This plan has been ncAewcd and: ❑Approved pp El Approved With Conditions ❑Disapproved Local Agrncy Signature: mite: Convromts/Special Conditions: S.ICEEUI-d(07103)-3/4 07f13f03