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WRITTEN MONITORING AND <br /> RESPONSE PLAN <br /> UNDERGROUND STORAGE TANK MONITORING PROGRAM <br /> This monitoring program must be kept at the UST location at all times.The information on this monitoring 209)468 3420 <br /> IL conditions of the operating permit.The permit holder must notify Environmental Health Department,a <br /> within 30 days of any changes to the monitoring procedures,unless required to obtain approval or a permit before r�ki� `13 <br /> the change.Required by CCR 2632(d)and 2641 (h). <br /> THREE PALMS GROCERY ' <br /> FACILITY NAME <br /> 6132 E. WATERLOO ROAD DATE �_ Q y <br /> FACILITY ADDRESS <br /> i <br /> I.Name(s)and Title(s)of the people responsible for performing the monitoring and/or maintenance <br /> 3 <br /> 1- K1toti <br /> A- hNil�rc MhC-0Itp,&iA <br /> 2.Desunuc the frequency of performing the monitoring for: CC,/ >/A!OV 1 <br /> TANKS L0�>/Nltll ' PIPING z <br /> 3.Describe the location(s)of where the monitoring will be performed. ie: location of sensors <br /> 7#041L OhNMUcn[ SRr+ edF .Z Plvs dum al dE [eu � �aa�SE2r /„tea S¢r✓�.�t gg. <br /> d t <br /> 4.Describe the following equipment for each underground storage tank. - ` 0 O , / �IS <br /> ks'• i <br /> Name and Model of Monitoring Panel <br /> Name and Model of Line Leak Detectors <br /> \„ Name and Model of Annular Sensors <br /> Name and Model of Piping Sensors a <br /> Name and Model of Dispenser Sensors /NCO/✓ !S p C(C <br /> Type of overfill prevention <br /> o,odl G/Suri >WG,0 'szr�sss <br /> 5.Do the Turbine Sensors and Dispenser Pan Sensors shut down the turbine? Yes 0 No❑ ; <br /> yes V No O <br /> Does the turbine shut down if a sensor is disconnected? Yes V No❑ <br /> Does the turbine shut down is the monitoring panel loses power? <br /> 6.How will the alarm history and subsequent maintenance be recorded? <br /> I ! �M4y MON11bIPIN4 C4falr AM/al1RWP1 +1> r*J� <br /> i <br /> } 7.Maintenance of the monitoring equipment must be performed at least once every 12 <br /> What <br /> Descn'be the preventive maintenance schedule and record' g for the monitoring eq equipment- <br /> annual monitoring certification be performed in? OJ c/1'1p EQ <br /> — - - - <br /> 44 <br /> ndaryronCoinmeM r-- <br /> mouse be rested installations <br /> livery s the s hesecondary h initial n containment must be <br /> tosted 6 months rmed amore mruary er 2003. <br /> installation.All seco ..� <br /> 8 Describe the training necessary for the operation of UST stem, including piping,and the moth <br /> T� re+n+u� <br /> equipment. lNr>RutK exPup-+� >+rF pP�Arror/ CnK�+ t <br /> l;ymten;i-IeWSTnfoniWringplan.doc `l <br /> 7/162002 <br /> 1 ,f <br />