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UNDERGROUND STORAGE TANK <br />MONITORING LAN - PAGE 2 <br />VI. DISPENSE MONITORING ! . <br />MONITORING OF AREAS BENEATH DISPENSER(S) IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) Mso. <br />I. CONTINUOUS ELECTRONIC MONITORING OF UNDE.iSPENSER CONTAINMENT (UDC) <br />PANEL MANUFACTURER: s�� Mss MODEL #: Msz. <br />M" 29 - 00 M54. <br />LEAK SENSOR MANUFACTURER: e— C>ryeoaz MODEL #(S): 212 <br />WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? ❑ a. YES b. NO Mss. <br />WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? a. YES ❑ b. NO M56. <br />WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? a. YES ❑ b. NO Msz <br />❑ 2. MECHANICAL ASSEMBLY (e.g., FLOAT AND CHAIN ASSEMBLY) IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK <br />ASSEMBLY MANUFACTURER: M56. MODEL #(S): M59. <br />3.VISUAL MONITORING DONE: 9 a. DAILY ❑ b. WEEKLY (Requires agency approval) M60. <br />❑ 4. NO DISPENSERS <br />4-99. OTHER (Specify) ®It! — 4Gi6i�? ®� t.s/ �� M61. <br />VTI. 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 />VIII. TRAINING <br />REFERENCE DOCUMENTS MAINTAINED AT FACILITY (Check all that apply) Mso. <br />1. g THIS UNDERGROUND STORAGE TANK MONITORING PLAN (Required) <br />2. OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT (Regyired) <br />3. THE FACILITY'S BEST MANAGEMENT PRACTICES (Required as of 7/1/2004); <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. F1 OTHER (Specify): M81 <br />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. <br />By July 1, 2004, this facility will have a "Designated UST Operator" who has passed the operator exam administered by the International Code Council (ICC). By July <br />1, 2004, and annually thereafter, the "Designated UST Operator" will Vain facility employees in the proper operation and maintenance of the UST systems. This <br />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, 2004, 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): Mas. <br />X. PERSONNEL'RESPONSIBILITIES <br />AS OF 7/1/2004, THE "DESIGNATED UST OPERATOR" IDENTIFIED IN SECTION III OF THE CURRENT UST OPERATING PERMIT APPLICATION — <br />FACILITY FORM WILL HAVE ULTIMATE AUTHORITY FOR PERFORMING THE MONITORING ACTIVITIES AND MAINTAINING LEAK DETECTION <br />EQUIPMENT COVERED BY THIS PLAN, AND WILL PERFORM AND DOCUMENT MINIMUM MONTHLY VISUAL INSPECTIONS OF THE FACILITY'S <br />UST SYSTEMS IN ACCORDANCE WITH 23 CCR § 2715(b). <br />XI. OWNER/OPERATOR SIGNATURE <br />CERTIFICATION: I cKlify that the information provided herein is true and accurate to the best of my knowledge. <br />OWNER/OP TOR SIG TURE XlC, REPRESENTING DATE: M91. <br />X.Owncr M90. <br />❑ Operator <br />OWNER/OPERATOR N `reor % : M92 <br />M93. <br />OWNER/OPERATOR TIITg®LE:ell <br />q }(prin+t): <br />py <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 />SJCEHD-d (07/03) - 3/4 0"""" <br />