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UNDERGROUND STORAGE TANK MONITORING PLAN—PAGE 2 VI:DISPENSER M©NITOMG MONITORING OF AREAS BENEATH DISPENSER(S)IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) Myo. ❑ 1.CONTINUOUS ELECTRONIC MONITORING OF UNDER DISPENSER CONTAINMENT(UDC) PANEL MANUFACTURER: M51 MODEL#: M52. LEAK SENSOR MANUFACTURER: M53. MODEL#(S): M54. WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? ❑ a.YES ❑ b.NO M55. WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M56. WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M57. ❑ 2.MECHANICAL ASSEMBLY(e.g.,FLOAT AND CHAIN ASSEMBLY)IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK ASSEMBLY MANUFACTURER: Msa MODEL#(S): M59. ❑ VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(Requires agency approval) M60 4.NO DISPENSERS ❑ 99.OTHER(Specify) M61. [.;EfHANEsD<IiEAKII►IETETIUN ❑ 1.WE HAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT WE MUST IMP y CEMENT ENHANCED LEAK M70. DETECTION(ELD)FOR THE UST(S)COVERED BY THIS PLAN.PER 23 CCR§2644.1,ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED VIII., TRAIlVING REFI!PENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) Mso. 1. THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 2. OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) 3. THE FACILITY'S BEST MANAGEMENT PRACTICES(Required as of 1/01/2005) 4. ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 5. ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 6. ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION" 7. ❑ SWRCB PUBLICATION:"WEEKLY MANUAL TANK GAUGING FOR SMALL UNDERGROUND STORAGE TANKS" 99. ❑ OTHER(Specify): M81. Personnel with UST monitoring responsibilities are familiar with all of the above documents relevant to their job duties and can access those documents when needed. 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 January 1,2005,and annually thereafter,the "Designated UST Operator"will train facility employees in the proper operation and maintenance of the UST systems. This training will include,but is not limited to,the following: Operation of the UST systems in a manner consistent with the facility's best management practices. ➢ The facility employee's role with regard to the leak detection equipment. ➢ The facility employee's role with regard to spills and overfills. ➢ Whom to contact for emergencies and leak detection alarms. For facility employees hired on or after January 1,2005,the initial training will be conducted within 30 days of the date of hire. IX� CO1TS/ DITI(►NAL INFtTI+fJN Please use this section to include any additional UST system monitoring-related information(e.g.,additional information required by your local agency): Mss. X"PERSONNEL RESPONSIIIIIITIES, AS OF 1/1/05, THE"DESIGNATED UST OPERATOR" IDENTIFIED IN SECTION III OF THE CURRENT UST OPERATING PERMIT APPLICATION— FACILITY FORM WILL HAVE ULTIMATE AUTHORITY FOR PERFORMING THE MONITORING ACTIVITIES AND MAINTAINING LEAK DETECTION EQUIPMENT COVERED BY THIS PLAN,AND WILL PERFORM AND DOCUMENT MINIMUM MONTHLY VISUAL INSPECTIONS OF THE FACILITY'S UST SYSTEMS IN ACCORDANCE WITH 23 CCR§2715(b). XI fa R/OPERATORSIGNA 'U[2E CERTIFICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. OWNER/OPERATOR SIGNA REPRESENTING DATE: M91 Owner M9o. ❑Operator OWNER/OPERATOR NAME(print:. M92. OWNER/OPERAT R TITLE: M93. (Agency Use Only) This plan has been reviewed and: ❑Approved ❑Approved With Conditions ❑Disapproved Local Agency Signature: Date: Comments/Special Conditions: SJCEHD-d(07/03)-3/4 07/23/03