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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORINGPLAN (Pagc2or2) VL UNDER DISPENSER CONTAINMENT(UDC)MONITORING L UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 49 vo-sat ❑ 1,CONTINUOUS ELECTRONIC MONITORING IM2.FLOAT AND THAM ASSEMBLY ❑ 7.6LECIRONIC STAND-ALONE ❑4.NO DISPENSERS ❑99.OTHER(Specify): ______ PANELMANUFACTURER; 490.55 MODELC 490-56. -....-___._....._-.._.._.___...._..__.—____..—_.--_--___ _ .—___._-.__�__ LEAK SENSOR MANUFACTURER: Mechanical 490.51 MODEL B(S): 490-59 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ® e,YES ❑b.NO 490.59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ® a,YES ❑b.NO 49460. FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑b.NO 490.61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER ® a.YES ❑b.NO 49062 E.UDC CONSTRUCTION IS ©I.SINGLE-WALLED ❑ 2.DOUBLE-WALLED 490"0 IF DOUBLE W4V.LED: as-o-w. UDC INTERSTITIAL SPACE IS MONITORED BY:-❑ 1.LIQUID - 2:1?RESSURE ❑3_VAC_U_UM _ _ A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE'AND VISUAL ALARMS ❑a YES ❑b.NO 49ad4b VII.PERIODIC SYSTEM TESTING I. ELD TESTING:THIS FACILITY HAS BEEN NOTIFIED BY THE S'rATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 49oe5 _ _LEAK DEfT10N(F.LDI MUST BF.PERFORMED. PERIODIC BLD IS PERFORMED EVERY 36 MONTHS AS REQUIRED_j2J CCR$2644 _�__ 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERT'36 MONTHS. 4906 -�3.SPIU.OUCKElS ARE TESTED ANNUALLY, 490.aa VIII.RECORDKEEPING The following 1"Wiloring/mnintenam records are kept for this facility. N Alarm logs 490-68. ❑Visual Inspection Records 490-6ab ❑Tank integrity testing results 490-sat. ❑SIR testing resuhs(and supporting dacamismation records). 49oaas ❑ Tank gauging results(and supporting documentation records), 49o.eaa ❑ATG Testing results(and supporting documentation records).49oarr ❑ Corrosion Protection,60-day logs ego-sea N Equipment maintenance and calibration records. 49e6ab _ IX.TRA WING N Personnel with UST monitoring responsibilities are familiar with all ofihc following documents relevant to their job duties, 49M% REFERENCE DOCUMENTS MAINTAINED AT]FACILITY(Check all that apply) N THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)4so-6% N OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)440-W ❑ CALIFORNIA UNDERGROUND STORAGETANK REGULATIONS 4W-69d ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 49069. ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"iso-59r ❑ SWRCE PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"49ac9a OTHER(Specify:mah,a+at This facility has a"Designated UST Operator"who has passed alit California UST System Operator Exam administered by the International Code Council(ICC). The"Designated UST Operator"will tram facility employees in the proper operation and rumntenance of the UST systems annually,and witbin 30 days of hire.This training will include,but is not limited to,the follmving: Opmadem of the UST systems in a mmmor consistent with the facility's best management practices D The facility employee's mlewidr regard to the monitoring equipment as specified in this UST Monitoring Plan D The facility employee's role with regard to spills wad overfills as specified in the UST Response Plan ➢ Names of contact persons)for emergencies and monitoring alarms.49o-xi X. COMMENTS/ADDIT-IONAL INFORMATION Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures arc attached in this plan.490n Flapper Valve XT.PERSONNEL RESPONSIBILITIES The UST Owner/Operator is responsible for ensuring that:1)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment covered by this plan occurs,2)all conditions that indicate a possible release are investigated,and J)all monitoring records are maintained properly. The following person(s)are responsible for performing the monitoring and equipment maintenance: NAME Service Contact Center 4m.72 TITLE 2.4 Hours 490-73 NAME Rudy Tover 494-W TITLE Market Manager 49075 The Designated Operator shall Worm a monthly visual inspection of the Facility,provide n report to the owner/aperator, and inform the owner/operator of any conditions that need Niovv up aotipn. XII.OWNER/OPERATOR SIGNATURE CER 11FICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. AP r' 49016 DATE: 190-12 31 Cal t r " PLICANT NAIM. (�pri^nt) 490-1° APPLICANTTITLE 490.19 ZIctN LL,QkIS� Environmental Compliance Manager for Circle K Stores Inc. UPCF UST-D(12/2007)2148