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UNIFIED PROGRAM CONSOLIDATED FORWF ` UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING 1. UAC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-54. 131.CONTINUOUS ELECTRONIC MONITORING ❑2.FLOAT AND CHAIN ASSEMBLY El3.ELECTRONIC STAND-ALONE 490-546 4.NO DISPENSERS 099.OTHER(Sped_fir): PANEL MANUFACTURER: ago=ss MODEL#: 490-5b. LEAK_SEMSoiMiANUFACTURE R: 490.171 MODEL 4(S): 490-58 DETECTION OFA LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑ a.YES [Ib.NO 490-59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ❑ a.YES ❑b.NO 490-60. FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑b.NO 440"61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ❑ a.YES ❑b.NO 490-62 2,UDC CONSTRUCTION IS [11.SINGLE-WALLED ❑2.DOUBLE-WALLED 490-63 IF DOUBLE WALLED: 4qo(tea UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ I•Ll UID 2_PRESSURE__Q 3.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO 490-606 VII.PERIODIC SYSTEM TESTING ❑ 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65. __LEAK DETECTION(ELD)MUST BE PERFORMED._PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS RFt UJRE�23 CCR§2644.1) 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490.66 3.SPILL BUCKETS ARE TESTED ANNUALLY. 490.67 VIII.RECORDKEEPING The following monitoring/maintenance records are kept for this facility: Alarm logs 490-68n C1Visual Inspection Records 490-68b El Tank integrity testing results 490.68c SIR testing results(and supporting documentation records). 490-68d ❑ Tank gauging results(and supporting documentation records). 49use ❑ATG Testing results(and supporting documentation records).490-68f ❑ Corrosion Protection 60-day logs 490-688 quipment maintenance and calibration records. 490-69h IX.TRAINING ❑Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their,job duties. 490-69a REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490-69b OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490-6% CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-6% STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"490-69f ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490-69g ❑ OTHER(Specify):M69h,M69i rile facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council(ICC). Ile"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 ➢ The facility employee's role with regard to time monitoring equipment as specified in this UST Monitoring Plan ➢ The facility employee's role with regard to spills and overfills as specified in the UST Response Plan ➢ Names of contact person(s)for emergencies and monitoring alarms.490-70 X. COMMENTS/ADDITIONAL INFORMATION Provide a ditional comments I a or indicate how many pages with additional information on specific mon'toring procedures are attached to this plan.490-n Ak ibfe_ ,ranit; Vi5i u., ( a_14r v S tAi'f. SA nn 904 yo 0tie4_ _(','rJ XI.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 rcicase are investigated,and 3)all monitoring records are maintained properly. The followinperson(s)are respons' le for performing the monitoring and equipment maim anee: / , NAME��' 490-rz TITLE ul t L'C�O,� —7 O r" � (2 f' 490-73 NAME 490-74 TITLE 490-75 The Designated Operator shall perfomm a monthly visual inspection of the facility,provide a report to the owner/operator, and inform the ownerloperator of any conditions that need follow-up action. XII.OWNER/OPERATOR SIGNATURE CERTIFICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. APPLICANT NATURF r Q 490-76 DATE: c, 490-77 */�, C)00 REPRESEKTING: I.Tank 0wu /O em_1or ?. a'tit. wner'D 10r 3.Auth rized Re 'v owner _ APPLICA T NAME(print); 4190-78 APPLICANT TITLE: 490-79 UPCF UST-D(12/2007)314