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Underground Storage Tank MonitoTng Plan —Page 2 of IN -022A - 3/5 www.unidoes.ore Rev. 10/I4/03 VL DISPENSER MONITORING M�O/yI1TORING OF AREAS BENEATH DISPENSER(S) IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) Wso. LM I. CONTINUOUS ELECTRONIC MONITORING OE UNDER DDIISPENSER CONTAINMENT (UDC) PANEL MANUFACTURER: Y�E/JE C,p �C(X%nut. MODEL JI: 72,15'-350 w+ T LEAK SENSOR MANUFACTURER: atss. MODEL JJ(S): atv. WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? f� YES F01 b. NO nus. �a WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? pl'a. ES ❑ b. NO ntw WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? a. YES ❑ b. NO Mn. ❑ 2. MECHANICAL ASSEMBLY (e.g., FLOAT AND CHAIN ASSEMBLY) IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK �� ASSEMBLY MANUFACTURER: nut MODEL A(S): hn9. pd'3.VISUAL MONITORING DONE: ❑ a. DAILY.WEEKLY <p.�:mg. yapp,.,yJ nno ❑ 4. NO DISPENSERS ❑ W. OTHER (Specify) ai61 VII. ENHANCED LEAK DETECTION ❑ I. WE HAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THATWEMUSTIMPLEMENTENHANCED LEAK n}10 DETECTION (ELD) FOR THE UST(S) COVERED BY THIS PLAN. PER 23 CCR §2644.1, ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED VIII. TRAINING REFE CE DOCUMENTS MAINTAINED AT FACILITY (Check all that apply) 1. HIS UNDERGROUND STORAGE TANK MONITORING PLAN (Required) a� 2. OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT (Required) 3. THE FACILITY'S BEST MANAGEMENT PRACTICES(Required as of January 1, 2005) V_1 4. ALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 5. �' CALIFORNIA UNDERGROUND STORAGE TANK LAW 6. ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND INVENTORY RECONCILIATION" ,,STATISTICAL 7.SWRCB PUBLICATION "WEEKLY MANUAL TANK GAUGING FOR SMALL UNDERGROUND STORAGE TANKS" 99. ❑ OTHER(Specify): AM Personnel with UST monitoring responsibilities are familiar with all ofthe above documents relevant to theirjob duties and can access those documents when needed. By January 1. 2005, this facility will have a "Designated UST Operator" has who passed the Califomia UST Sylem Operator Exam administered by the International Code Council (ICC). By July I, 2005, and annually thereafter, the "Designated UST Operator" will Vain facility employees in the proper operation and maintenance of the UST systems. This training will include, but is not limited m, 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 equipmemL The facility employee's role with regard to spills and overfills. > Whom to contact for emergencies and leak detection alarms. For facility employees hired on or after July I, 2005, the initial training will be conducted within 30 days of the date of hire. IX. COMMENTS/ADDTTIONAL INFORMATION Please use this section la include any additional UST systemmonitoring-related information (e.g., additional information required by your local agenq): nus. Note regarding Section X. Pending certification of a Designated UST Operator, the following person has authority for performing the monitoring activities and maintaining leak detection equipment covered by this plan. NAME: JOB TITLE: X. PERSONNEL RESPONSIBILITIES AS OF JANUARY 1, 2005, THE "DESIGNATED UST OPERATOR" IDENTIFIED IN SECTION III OF THE CURRENT UST OPERATING PERMIT APPLICATION —FACILITY FORM WILL HAVE ULTIMATE AUTHORITY FOR PERFORMING THE MONITORING ACTIVITIES AND MAINTAINING LEAK DETECTION EQUIPMENT COVERED BY THIS PLAN, AND WILL PERFORM AND DOCUMENT MINIMUM MONTHLY VISUAL INSPECTIONS OF THE FACILITY'S UST SYSTEMS IN ACCORDANCE WITH 23 CCR § 2715(b). XI. OWNER/OPERATOR SIGNATURE CERTIFICATION: 1 certify that the information provided herein is true and accurate to the best of my knowledge. O RATOR SI REPRESENTING DATE: Nvt ❑ Owner sue. ❑ Operator d 21 O R/OPERATOR NAM Mv' OWNER/OPERATOR TITLE: nws. (Agency Use Only) This plan has been reviewed and: ❑ Approved ❑ Approved With Conditions ❑ Disapproved Local Agency Signature: Date: Commenrs/Special Conditions: IN -022A - 3/5 www.unidoes.ore Rev. 10/I4/03