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1 , ` r UNDERGROUND STORAGE TANK MONITORING PLAN-PAGE 2 MONITORING OF AREAS BENEATH DISPENSER(S)IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) ❑ 1.CONTINUOUS ELECTRONIC MONITORING OF UNDER DISPENSER CONTAINMENT(UDC) M52. MODEL#: PANEL MANUFACTURER: M53. MODEL#(S): M54. LEAK SENSOR MANUFACTURER: Mss WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? ❑ a.YES El b.NO M56. WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? M57 WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES C1 b.NO ❑ 2.MECHANICAL ASSEMBLY(e.g.,FLOAT AND CHAIN ASSEMBLY)IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK M59 ASSEMBLY MANUFACTURER: M58. MODEL#(S): M60. ❑ 3.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(Requires agency approval) ❑ 4.NO DISPENSERS M61. ❑ 99.OTHER(Specify) M70. ❑ I. B HAVE BEEN NOTIFIED BY ThE STATE WATER PWS.3URCES CC.NTROL nOP.PD T�IAT WE)vfUST IMPLEMENT ENHANCED LEAK W DETECTION(ELD)FOR THE UST(S)COVERED BY THIS PLAN.PER 23 CCR§2644.1,ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED r ' M80. REFE NCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) 1, [THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 2. �' OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) 3. ❑ THE FACILITY'S BEST MANAGEMENT PRACTICES(Required as of 7/1/2004) 4. ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 5. ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 6. ❑ STATE WATER RESOURCES 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" M81 99.❑ OTHER(Specify): Personnel with UST monitoring responsibilities are familiar with all of the above documents relevant m their job duties and can access those documents when needed. By this facility will have a"Designated UST Operator"who has passed the operator exam administered by the International Code Council(ICC). By ®@ and annually 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 leak detection alarms. 19 For facility employees hired on or after July 1,2004,the initial training will be conducted within 30 days of the date of hire. M85. Please use this section to include any additional UST system monitoring-related information(e.g.,additional information required by your local agency): PER UST PERATING PERMIT R"IDENTIFIED IN AS OF 7/1/2004,THE"DESIGNATT TEOUTHORITY OR PERFORMING SECTION THE MONITORING ACTIVITIES AND MAINTAINING LEAKPDE DETECTION FACNT ILITY FORM WILL HAVE UL EQUIPMENT COVERED BY THIS PLAN,AND WILL PERFORM AND DOCUMENT MINIMUM MONTHLY VISUAL INSPECTIONS OF THE FACILITY' UST SYSTEMS IN ACCORDANCE WITH 23 CCR§2715(b). CERTIFICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. 191. O R/ ERATOR SIGNATURE REPRESENTING DATE: Owner M90 . \ .. ❑Operator �1 M93 M9z. OWNER/OPERATOR TITLE: OWNER/ RATOR NA (print): 0A.* iwig (Agency Use Only) This plan has been reviewed and: ❑Approved ❑Approved With Conditions ❑Disapproved Date: Local Agency Signature: Comments/Special Conditions: 07/23/03 SJCEHD-d(07/03)-3/4