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UNDERGROUND STORAGE TANK <br /> MONITORING PLAN-PAGE 2 <br /> VI. DISPENSER MONITORING <br /> MONITORING OF AREAS BENEATH DISPENSER(S)IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) Myo. <br /> ❑ 1.CONTINUOUS MONITORING OF UNDER DISPENSER CONTAINMENT(UDC) _ <br /> PANEL MANUFACTURER: \kA ( OM51. MODEL#: ` 1 l? G' ' M52. <br /> LEAK SENSOR MANUFACTURER: 2—& U L S M53. MODEL#(S): M54 <br /> WILL DETECTION OF A LEAK IN THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? a.YES ❑ b.NO M55, <br /> WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? �'a.YES Elb.NO M56. <br /> WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? fiT a.YES ❑ b.NO M57. <br /> ❑ 2.MECHANICAL CONTINUOS MONITORING(e.g.,FLOAT AND CHAIN ASSEMBLY)IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK <br /> MANUFACTURER: Mss. MODEL#(S): M59. <br /> ❑ 3.VISUAL MONITORING DONE: '$ a.DAILY ❑ b.WEEKLY Mho. <br /> ❑ 4.NO DISPENSERS <br /> ❑ 99.OTHER(Specify) M61 <br /> VII. ENHANCED LEAK DETECTION <br /> ❑ 1.WE HAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT WE MUST PERFORM ENHANCED LEAK Myo <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) Mso. <br /> l. 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 January 1,2005) <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): Mai <br /> Personnel with UST monitoring responsibilities are familiar with—all with-allof the above documents relevant to their job duties an can access ose ocuments w en 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 facility 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): Mss. <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 TITLE 23 CCR§2715(c),AND WILL PERFORM AND DOCUMENT MINIMUM MONTHLY <br /> VISUAL INSPECTIONS OF THE FACILITY'S UST SYSTEMS IN ACCORDANCE WITH TITLE 23 CCR§2715(c). <br /> XI. 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 SIGNATURE REPRESENTING DATE: 1_.' CY L M91. <br /> j (X Owner M9o. <br /> Operator <br /> OWNER/OPERATOR NAME M92' OWNER/OPERATOR TITLE: <br /> (Print):. M93. <br /> (Agency Use Only) This plan has been reviewed and: ❑Approved ❑Approved With Conditions ❑Disapproved <br /> Local Agency Signature: Date: <br /> Comments/Special Conditions: <br /> hwfwrc-d(9/24/04)-3/4 <br />