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UNDERGROUND STORAGE TANK MONITORING PLAN - PAGE VI. DISPENSER MONITORING MONITORING OF AREAS BENEATH DISPENSER(S) IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) M50. 1. CONTINUOUS ELECTRONIC MONITORING OF UNDER DISPENSER CONTAINMENT (UDC) M51 TL - E O M52. MODEL #: -5- PANEL MANUFACTURER: V 0 "1 LEAK SENSOR MANUFACTURER: Vz- e-tQ L Mss. MODEL #(S): 7q43,80— 63 M54. WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? [ a. YES ❑ In. NO Mss. 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? . YES ❑ b. NO M57. ❑ 2. MECHANICAL ASSEMBLY (e.g., FLOAT AND CHAIN ASSEMBLY) IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK ASSEMBLY MANUFACTURER: M5S MODEL #(S): Mss. ❑ 3. VISUAL MONITORING DONE: ❑ a. DAILY ❑ b. WEEKLY (Requires agency approval) M60. ❑ 4. NO DISPENSERS ❑ 99. OTHER (Specify) M6L VII. ENHANCED LEAK DETECTION ❑ 1. WE HAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT WE MUST IMPLEMENT 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. TRAINING REFERENCE DOCUMENTS MAINTAINED AT FACILITY (Check all that apply) Mao. 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): Msl 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 USTOperator" 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. COMMENTS/ADDITIONAL INFORMATION dditional UST system monitoring -related information(e.g.,yadditional infpoyrm�ation required by�your agency): Mss. Please section topiynclude any additional /uusy]e'this local $ vi S o- 0 X11' X. PE ONNEL RESPONSIBILITIES 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). XL OWNER/OPERATOR SIGNAT CERTIFICATION: I certify that the information provided herein is true and accurate to the best of my knowledge. OWNER/OPARATOR SIGNATURE REPRESENTING DATE: M91. ❑ Owner M9o. ❑ Operator 0!�/ + Lo OWNER/OPERATOR N (print): M92. OWNER/OPERATOR TITLE: Mss. 'Joe. (Agency Use Only) This plan has been reviewed and 0 Approved ❑ Approved With Conditions DisapproXed Local Agency Signature: Date: Comments/Special Conditio SJCEHD-d (07/03) - 3/4 07/23/03