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Sep 30 04 02:34p RR,AMLNDER SINGH 2092@L10142 p.4 <br />Underground Storage Tank Monitoring Plan — Page 2 of 2 <br />VI. DISPENSER MOMffOPJNG <br />OF AREAS BENEATH DISPENSER(S) IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) Msa <br />7TORING <br />CONTINUOUS ELECTRONIC MONITORING OF UNDER DISPENSER CONTAINMENT (UDC) <br />�-^ �, �~+ _ <br />PANEL MANUFACTURER: /fes ��, ��W 5151 MODEL #: NIS, <br />LEAK SENSOR MANUFACTURER: Sts3. ,MODEL #(S): ��°.� ��[j \154. <br />WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? ❑ a. YES ❑ b. NO r rss. <br />WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a. YES ❑ b. NO S56 <br />WILL FAILUREIDISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a. YES ❑ b. NO &157. <br />❑ 2. MECHANICAL ASSEMBLY (e.g., FLOAT AND CHAIN ASSEMBLY) IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK <br />ASSEMBLY MANUFACTURER: N1158 MODEL #(S): Z?y 32-0 -9®,?' %t59 <br />[y'3.VISUAL MONITORING DONE: ❑ a. DAILY EF7b. WEEKLY pt�yu��By�pro.at) Sty <br />C1 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 IMPLEMENT ENHANCED LEAK b170. <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 />REFSWCE DOCUMENTS MAINTAINED AT FACILITY (Check all that apply) Man, <br />L. tff/TH)S 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 onanuary 1, 2005) <br />4. [}CALIFORNIA UNDERGROUND <br />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 />INVENTORY RECONCILIATION" <br />,,,,STATISTICAL <br />7, SWRCB PUBLICATION: "WEEKLY MANUAL TANK GAUGING FOR SMALL UNDERGROUND STORAGE TANKS" <br />99. ❑ OTHER (Specify): n131 <br />Personnel with UST monitoring responsibilities are familiar with all of the above docutmermts 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 t, 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 />i Operation of the UST systems in a manner consistent with the facility's best management practices. <br />Y 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 />'r Whom to contact for emergencies and leak detection alarms. <br />For facility employees hired on or after July[, 2005, the initial training will be conducted within 30 days of the date of hire. <br />IX. COMMENTS/ADDITIONAL INFORMATION <br />Please use this section to include any additional UST system monitoring -related information (e.g., additional information required by your local agency): ills$. <br />Note regarding Section X. Pending certification of a Designated UST Operator, the following person has authority for performing the monitoring <br />activities and maintaining leak detection equipment covered by this plan. NAME: JOB TITLE: <br />X. PERSONNEL RESPONSIBILITIES <br />_ <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, AND WILL PERFORM AND DOCUMENT MINIMUM MONTHLY VISUAL INSPECTIONS <br />OF THE FACILITY'S UST SYSTEMS IN ACCORDANCE WITH 23 CCR § 2715(b). <br />XI. OWNERIOPERATOR SIGNATURE <br />CERTIE' r T N: I certif that thcj!IfwnYlation provided herein is true and accurate to the b 5t of my knowledge. <br />OWN OP TOR S REPRESENTING <br />DATE: 4191 <br />❑ O viler rom <br />o <br />rator <br />OWNER, PERATO ME (print): M92. <br />U ; ER ATOR TITLE: "193. <br />(.4gencr Lire 0n11) This plan has been reviewed and: ❑ Approved ❑ Approved With Conditions ❑ Disapproved <br />Local Agency Signature: Date: <br />Comments/Special Conditions: <br />UN -022A - 3/5 www.unidocs.org Rev. 10/14103 <br />