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o <br /> Underground Storage Tank Monitoring Plan—Page 2 of 2 <br /> <.. r... VI._DISPENSER MONITORING , <br /> r..,..,J <br /> MONITORING OF AREAS BENEATH DISPENSER(S)IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) Myo. <br /> ❑ 1.CONTINUOUS ELECTRONIC MONITORING OF UNDER DISPENSER CONTAINMENT(UDC) <br /> PANEL MANUFACTURER: Hu MODEL#: M52 <br /> LEAK SENSOR MANUFACTURER: MS3 MODEL#(S): M54. <br /> WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? ❑ a.YES ❑ b..NO ntss. <br /> WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? I ❑ a.YES ❑ b.NO <br /> WILL FAILUREIDISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO Ms7. <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): Msg. <br /> 3 SUAL MONITORING DONE: ❑ a.DAILY Mho. <br /> © ❑ b.WEEKLY tlieeQuira egrncy approval) <br /> 4.NO DISPENSERS <br /> ❑ 99.OTHER(Specify) M6t. <br /> '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 /> y; _..VIII. TRAININGl <br /> z <br /> REFS CE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) No, <br /> 1. S UNDERGROUND STORAGE TANK MONITORING PLAN(Required) <br /> 2. MjOPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) <br /> 3. HE FACILITY'S BEST MANAGEMENT PRACTICES(Required as of January I,2oo5) <br /> 4. WCALIFORNIA 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): Mst <br /> Persotmel 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 I,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 facilit),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 /> ➢ Whom to contact for emergencies and leak detection alarms. <br /> For facility employees hired on or after July 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): M95 <br /> Noteregarding Section X.Pending certification of a Designated USF 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 /> �93LA--_ -k -4 ksu� %__ et k-ft VIA i P i Yo <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,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 /> CERTIFICATION:I certify that the information provided herein is true and accurate to the best of my knowledge, <br /> OWNER/OPERATOR SIGNATURE T, <br /> RESENTING DATE: 9; <br /> it � 9xweer Mso. �rater <br /> OWNER/OPERATOR NAME(print): M92. OWNER/OPERATOR TITLE: K193 <br /> (Agency Use Only) This plan has been reviewed and:. Approved ❑Approved With Conditions ❑Disapproved <br /> Local Agency Signature: Date: t! <br /> Comments/Special Conditions <br /> UN-022A-315 www.unidocs org Rev.I0/14/03 <br />