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.a.. �r <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN — PAGE 2 <br /> VL DISPENSER MONITORING <br /> M50. <br /> MONITORING OF AREAS BENEATH DISPENSER(S)IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) <br /> ❑ 1.CONTINUOUS ELECTRONIC MONITORING OF UNDER DISPENSER CONTAINMENT(UDC) MSz. <br /> PANEL MANUFACTURER: Myr MODEL 4: <br /> LEAK SENSOR MANUFACTURER: MSS. MODEL#(S): M54 <br /> WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? ❑ 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? ❑ a.YES ❑ b.NO Msr. <br /> CR,2.MECHANICAL ASSEMBLY(e.g.,FLOAT AND CHAIN ASSEMBLY)IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK <br /> ASSEMBLY MANUFACTURER: Bravo .;1a-44 t CL.e.stn MsaMODEL#(S): Mss. <br /> M60. <br /> ❑ 3.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(awuirce agency eppmvel) <br /> ❑ 4.NO DISPENSERS <br /> M61. <br /> ❑ 99.OTHER(Specify) <br /> VII. ENHANCED LEAK DETECTION <br /> ❑ L WE HAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT WE MUST IMPLEMENT ENHANCED LEAK M'ro. <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 /> I. 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 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): Mar <br /> Personnel with UST monitoring responsibilities are familiar with all of the 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 operator exam administered by the International Code Council(ICC). By <br /> January I.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 /> Y 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 /> Y The facility employee's role with regard to spills and overfills. <br /> Y 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. 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): Mas. <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 /> XL 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 SIGN TURE REPRESENTING DATE: M91. <br /> ❑Owner Mso. .,Z &/L <br /> ®Operator <br /> OWNER/OPERAT RNAME(print): Ake 6 4afo� d �Msz OWNER/OPERATOR TITLE: l� (' kf&A,7w M93. <br /> t <br /> (Agency Use Only) This pla en reviewed ail <br /> ,I,V6Approved ❑A proved With Conditions` ,, ❑Di pproved <br /> Local Agency Signamre� "4 (A , Date: lCl� 2.f e -7 <br /> Comments/Special Conditions: <br /> SJCEHD-d(07/03)-3/4 07/23/03 <br />