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n <br />n <br />UNDERGROUND STORAGE TANK <br />MONITORING PLAN - PAGE 2 <br />VI° DISPENSER MONITORING <br />MONITORING OF AREAS BENEATH DISPENSER(S) IS• PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) Myo. <br />❑ 1. CONTINUOUS MONITORING OF UNDER DISPENSER CONTAINMENT (UDC) <br />PANEL MANUFACTURER: M51. MODEL #: M52. <br />LEAK SENSOR MANUFACTURER: BEAUDREAU M53. MODEL #(5,): 404 <br />WILL DETECTION OF A LEAK IN THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? ❑ a. YES CKb.NO <br />WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? a. YES ❑ b. NO M56. <br />WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ;R a. YES ❑ b. NO Ms7. <br />❑ 2. MECHANICAL CONTINUOS MONITORING (e.g., FLOAT AND CHAIN ASSEMBLY) IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK <br />MANUFACTURER: M" MODEL #(S): Mss. <br />❑ 3.VISUAL MONITORING DONE: ❑ a. DAILY ❑ b. WEEKLY M60. <br />❑ 4. NO DISPENSERS <br />❑ 99. OTHER (Specify) M61. <br />VII. ENHANCED LEAK DETECTION <br />❑ I. WE HAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT WE MUST PERFORM ENHANCED LEAK M70. <br />DETECTION (ELD) FOR THE UST(S) COVERED BY THIS PLAN. PER 23 CCR §2644.1, ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED <br />VIII. TRAINING <br />REFERENCE DOCUMENTS MAINTAINED AT FACILITY (Check all that apply) Mao. <br />L THIS UNDERGROUND STORAGE TANK MONITORING PLAN (Required) <br />2. OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT (Required) <br />3. THE FACILITY'S BEST MANAGEMENT PRACTICES (Required as of January 1, 2005) <br />4. CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS <br />5. CALIFORNIA UNDERGROUND STORAGE TANK LAW <br />6. ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND <br />STATISTICAL INVENTORY RECONCILIATION" <br />7. ❑ SWRCB PUBLICATION: "WEEKLY MANUAL TANK GAUGING FOR SMALL UNDERGROUND STORAGE TANKS" <br />Ms1. <br />99. ❑ OTHER (Specify): <br />Personnel with UST monitoring responsibilities are familiar with all ofthe above documents relevant to theirjob duties and can access those documents When needed. <br />By January 1, 2005, this facility will have a "Designated UST Operator" who has passed the California UST Sytem Operator Exam administered by the International <br />Code Council (ICC). By July 1, 2005, and annually thereafter, the "Designated UST Operator" will train facility employees in the proper operation and maintenance <br />of the UST systems. This training will include, but is not limited to, the following: <br />Operation of the UST systems in a manner consistent with the facility's best management practices. <br />The facility employee's role with regard to the leak detection equipment. <br />➢ The facility employee's role with regard to spills and overfills. <br />A Whom to contact for emergencies and leak detection alarms. <br />For facility employees hired on or after July I, 2005, the initial training will be conducted within 30 days of the date of hire. <br />IX. COMMENTSADDITIONAL INFORMATION <br />Please use this section to include any additional UST system monitoring -related information (e.g., additional information required by your local agency): Mss, <br />X. PERSONNEL RESPONSIBILITIES <br />AS OF JANUARY 1, 2005, THE "DESIGNATED UST OPERATOR" IDENTIFIED IN SECTION III OF THE CURRENT UST OPERATING PERMIT <br />APPLICATION – FACILITY FORM WILL HAVE ULTIMATE AUTHORITY FOR PERFORMING THE MONITORING ACTIVITIES AND MAINTAINING <br />LEAK DETECTION EQUIPMENT COVERED BY THIS PLAN TITLE 23 CCR § 2715(c), AND WILL PERFORM AND DOCUMENT MINIMUM MONTHLY <br />VISUAL INSPECTIONS OF THE FACILITY'S UST SYSTEMS IN ACCORDANCE WITH TITLE 23 CCR § 2715(c). <br />XI: OWNER/OPERATOR SIGNATURE <br />CERTIFICATION: I certify that the information provided herein is true and accurate to the best of my knowledge. <br />OWNER/OPERATOR SIGNATURE REPRESENTING <br />° ❑ Owner M9o. <br />DATE: M91. <br />r <br />3 —0 <br />°finO rator <br />OWNER/OPERATOR NAME (prin : msz. <br />OWNER/OPERATOR TITLE: M93. <br />Richard Tirapelle <br />Lead Automotive Mechanic <br />(Agency Use Only) This plan has been reviewed and: ❑ Approved ❑ Approved With Conditions ❑ Disapproved <br />Local Agency Signature: Date: <br />Comments/Special Conditions: <br />hwfwrc-d (9/24/04) - 3/4 <br />M54. <br />M55. <br />