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� r <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) M50. <br /> 1.CONTINUOUS ELECTRONIC MONITORING OF UNDER DISPENSER CONTAINMENT(UDC) <br /> V <br /> PANEL MANUFACTURER: dmveK—doel- — M51. MODEL#: BVgZYO- 6ZZ— M52, <br /> LEAK SENSOR MANUFACTURER: n^ M53. MODEL#(S): 7g!V e `U—ZDS M54. <br /> WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? X a.YES ❑ b.NO Mss. <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? Xa.YES ❑ b.NO M57. <br /> ❑ 2.MECHANICAL ASSEMBLY(e.g.,FLOAT AND CHAIN ASSEMBLY)IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK <br /> ASSEMBLY MANUFACTURER: Mss MODEL#(S): M59. <br /> ❑ 3.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(Requires agency approval) M60. <br /> ❑ 4.NO DISPENSERS <br /> ❑ 99.OTHER(Specify) M61. <br /> VII, ENHANCED LEAK DETECTION <br /> ❑ 1.WE HAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT WE MUST IMPLEMENT 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) M80. <br /> L [ HIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) <br /> 2. &J- PPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) <br /> 3. L-4-THE FACILITY'S BEST MANAGEMENT PRACTICES(Required as of 1/01/2005) <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 /> 99. ❑ OTHER(Specify): M81 <br /> Personnel with UST monitoring responsibilities are familiar with all of the above documents relevant to their job 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 operator exam administered by the Intemational Code Council(ICC). By <br /> January 1,2005,and annually thereafter,the "Designated UST Operator"will train facility employees in the proper operation and maintenance of the UST systems. <br /> 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 /> ➢ Whom to contact for emergencies and leak detection alarms. <br /> For facility employees hired on or after January 1,2005,the initial training will be conducted within 30 days of the date of hire. <br /> IX. COMMENTWADDITIONAL 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 /> D p W t-K"P f cv 4-1 j')Q, +U VGwt <br /> r <br /> X. PERSONNEL RESPONSIBILITIES <br /> AS OF 1/1/05, THE"DESIGNATED UST OPERATOR" IDENTIFIED IN SECTION III OF THE CURRENT UST OPERATING PERMIT APPLICATION— <br /> FACILITY FORM WILL HAVE ULTIMATE AUTHORITY FOR PERFORMING THE MONITORING ACTIVITIES AND MAINTAINING LEAK DETECTION <br /> EQUIPMENT COVERED BY THIS PLAN,AND WILL PERFORM AND DOCUMENT MINIMUM MONTHLY VISUAL INSPECTIONS OF THE FACILITY'S <br /> UST SYSTEMS IN ACCORDANCE WITH 23 CCR§2715(b). <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 DATE: M91. <br /> ®Owner Mx1. <br /> 12 ®Operator <br /> OWNER/OPERATOR NAME(print): � M92. OWNER/OPERATOR TITLE: M93. <br /> /1/leti Lee /�9d Kd5 owrr -o a eu f <br /> (Agency Use Only) This plan has en reviewed and: V Approved ❑Approved With Condition�s// ElDissapppproved <br /> Local Agency Signature: l Date: <br /> IC <br /> c <br /> Comments/Special Conditions: <br /> SJCEHD-d(07/03)-3/4 07/23/03 <br />