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UNDERGROUND STORAGE TANK MONITORING PLAN —PAGE 2 E= VI.DISPENSER MONITORING Wo. IS PERFORMED USING THE FOLLOWING METHODS)(Check all that apply) FONIIGF AREAS BENEATH DISPENSER(S) i vtr_. Hsi. _ MODEL**: uts4. '"�� lr c � � OUSELECTRONICMONITORING OF UNDER DISPENSER CONTAINiVtENT( �Mns=. MODEL#(S): utss. L MANUFACTURER: J a YES ❑ 'o.NOSENSORMANUFACTURER: b.NO vts6[� a.YES ❑DETECTION OF A LEAK INTO THE UDC TRIGGER AUD(BUO`�yp�VISUAL AI—'��S Yb.ti0 \4s' A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUT WN, [� a. ES ❑GGER AUTOMATIC PUMP SHUTDO FAILURE/DtSCONNECTION OF UDC tilONITCRING SYS IINUDCTRIPS HEAR VALVE IN CASE 05+ \4s9 ICAL ASSEMBLY(e.,.,FLOAT AND CHAIN ASSEMBLY) xsa. MODELr(S): boMBLY MANUFACTURER: b.WEEKI Y 2cgci ;,=r F 3.VISUALMONITORfiIGDUiQE: a c�� utbi ❑ 4.NO DISPENSERS ❑ 99.OTHER(Specify) u470. I. `ZCED I,E DETECTION ER RESOURCES CONTROL BOARD THAT WE MUS i 2viPLEMENT ENHANCED LEAKL IRED WE HAVE BEEN NOTIFIED BY THE STATE VAT 2644.1.ELD IS PERFORMED EVERY 36 MONTHS AS RE DETECTION(ELD)FOR THE UST(S)COVERED BY THIS PLAN.PER 23 CCR utso VIII. TRAINIi�G REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that aPP1Y) 1. THIS UNDERGROUND STORAGE TANK° ONITORING PLAN(Required) ?. �1 OPERATING MANUALS FOR ELECTRONIC MONITORING uireQd EQUIPMENT 7/1/2004) uire ) ,3. (� THE FACILITY'S BEST MANAGEMENT PRACTICES(Req 4. Q CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 5. ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW WATER RESOURCES CONTROL BOARD (SWRCB) PLBLICATICN: "HANDBOOK FOR TANK OWNERS - MANUAL A� 6. (Q STATE STATISTICAL INVENTORY RECONCILIATION" 7, ❑ S ATISRCB PUBLICATION:"WEEKLY MANUAL TANK GAUGING FOR SMALL UNDERGROUN duties O and an access those documer,s--en needed.lv 99•❑ OTHER(Specify):___ ____-- by the ' orator"who iainpfacility employeesenache proper 1tope operation and maintenance of the UST IC ste By I Personnel with UST monitoring responsibilities are familiar with all of the above documents relevant m ad their Jo By July 1,2004,this facility Wil l have a"Designated UST Op 1,2004, and annually thereafter, the "Designated UST Operator"will t trainin,will include,but is not limited to,the following: I > operation of e 'svrole with a manner consistent w and to the leak detection equipment.� best manasement practices. > The facility > The facility employee's role with regard to spills and alarms. > Whom to contact for emergencies and leak detection alarms• ays NFOR ATI®N For facility employees hired on or after July 1,2004,the initial training will b�conductedwithin 3AL I the date of hire. 1111 X85 IX. COMN NTS/ additional intui Mation regwred by your al agency): 12 L Please use this section to include any addit�io�al US�T1sYs�m0 �j re.ateTn� anon(e.g., `Jhp" X. PERSONNEL RESPONSIRILITIEST UST OPERATING PERMIT APPLICATION— TIMATE AUTHORITY VISUAL INSPECTIONS OF THE FACILITY'S UL FOR PERFORMING THE MONITORING ACTIVITIES AND MAINTAINING LEAK DETECTION AS OF 711/2004,THE"DESIGNATED ATED UST OPERATOR" IDENTIFIED IN SECTION III OF THE CURREN FACILITY FORM WILL HAVE AND WILL PERFORM AND DOCUbIENT MINIMUM MONTHLY EQUIPMENT COVERED BY THIS PLAN, UST SYSTEMS N ACCORDANCE WITH 23 CCR§2715(b). (3`YNER/®AERATOR SIGNATU N91 ERTIFICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. C REPRE_ SSG DATE: OV,-,,EPv'OPERATOR SIGNATUR)j gOwner ham. `l 1�A ❑Operator M9_ OWNER/OPERATOR TITLE: OWNER/OPERATORNAME(print): ' - 0tL &-- K ❑Approved With Conditions C]Disapproved (Agency Use Only) This plan has been review, and: pAproved 1 Date: Local Agency Signature: comments/Special Conditions: