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�NIFIED PROGRAM CONSOLIDATED FORJ& UNDERGROUND STORAGE TANK MONITORINGPLAN (Pa9e2of2) VL UNDER DISPENSER CONTAINMENT(UDC)MONITORING 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-548 490-546 El LCONTINUOUS ELECTRONIC MONITORING iK 2.FLOAT AND CHAIN ASSEMBLY El3.ELECTRONIC STAND-ALONE ❑ 4.NO DISPENSERS ❑99.OTFIER(Species_ PANEL MANUFACTURER: 49ass MODEL#: 49o-s6. ------- —'--- -- ------ ------------------- LEAK SENSOR MANUFACTURER: 49ast MODEL#(S): 490-50. DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑ a.YES g[h.7NN 49x59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN a YES b.N 4�60 FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. YES 490fir UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. a YE 49oa2 2.UDC CONSTRUCTION IS X L SINGLE-WALLED ❑2.DOUBLE-WALLED 490.63 IF DOUBLE WALLED: UDC INTERSTITIAL SPACE IS MONITORED BY: (]1.1,QUID_g 2.PRESSURE [13.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO VII. PERIODIC SYSTEM TESTING L ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65, LEAK DETECIIZ D_MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED.(23 CCR§2644.1)__ 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490-66 3.SlPIL L BUCKF,TS ARE TESTED ARMIALLY. 49a67 VIII. RECORDKEEPING The following monitoring/maintenance records are kept for this facility: Alarm logs 490688 ❑Visual Inspection Records 490fi86 N Tank integrity testing results 490fi8c SIR testing results(and supporting documentation records). 49a68d ❑ Tank gauging results(and supporting documentation records). 499-e8e ❑ATG Testing results(and supporting documentation records).490-68f ❑ Corrosion Protection 60-day logs 4%.680 Equipment maintenance and calibration records. 4906gh IX.TRAINING �]Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to theirjob duties. 490s a REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) pwpwpw��III THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490-696 OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)49a69c CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d CALIFORNIA UNDERGROUND STORAGE TANK LAW 49x698 ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"49a69r ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"49098 ❑ OTHER(Specify):m69h,m69i Pg This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council(ICC). The"Designated UST Operator'will train facility employees in the proper operation and maintenance of the UST systems annually,and within 30 days of hire.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 D The facility employee's role with regard to the monitoring equipment as specified in this UST Monitoring Plan D The facility employee's role with regard to spills and overfills w specified in the UST Response Plan D Names of contact persons)for emergencies and monitoring alarms.490-70 CR-)COMMENTS/ADDITIONAL INFORMATION Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan.490-91 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 3)all monitoring records are maintained properly. The following persons)are responsible for performing the monitoring and equipment maintenance: NAME 49 72 TITLE 49x73 NAME 490-74 TITLE 49x95 The Designated Operator shall perform a monthly visual inspection of the facility, provide a report to the owner/operator, and inform the owner/operator of any conditions that need follow-up action. XII.OWNERIOPERATOR SIGNATURE CERTIFICATION: I certify that the information provided herein is true and accurate to the best of my knowledge. APPLICANT SIGNA RE 490.76 DATE: 490.]7 re ; 3 APPLICANT NAME(print) 4911 APPLICANT TITLE: 090-79 Y'0.✓ �- UPCF UST-D(12/2007)3/4