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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VL UNDER DISPENSER CONTAINMENT(UDC)MONITORING L UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD g9as4. ❑ 1.CONTINUOUS ELECTRONIC MONITORING ❑2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 49asw ❑� 4.NO DISPENSERS ❑99.OTHER 5 i : PANEL MANUFACTURER: 49-66 MODEL q: �— 49-s6. LEAK SENSOR MANUFACTURER: 49asr DETECTION OFA LEAK INTO MODEL#(S): -vasa THE UDC 7RIGGERS AUDIBLE AND VISUAL ALARMS ❑ a.YES ❑b.NO 490-59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ❑ a.YES ❑b.NO 49-60. FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGG ERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑b.NO 49-61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ❑ a.YES ❑b.NO 49-62 2.UDC CONSTRUCTION IS ❑1.SINGLE-WALLED ❑2.DOUBLE-WALLED9D �N 49062 IF DOUBLE WALLED: _UDC INTERSTITIAL SPACE IS MONITORED BY: 1.LI UID 2.PRESSURE 3.VACUUMqw a.A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL .YES ❑b.NO 49 bVII.PERIODIC SYSTEM TESTING 1.ELDTESTING:THIS FACILITY HAS BEEN NOTIFIED BY THB STATE WATER RESOURCES CONTHAT ENHANCED 49-65.LEAK DETE D MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHD. 23 CCR 2641.12.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 49066®3.SPILL BUCKETS ARE TESTED ANNUALLY. 49-61VIII.RECORDKEEPING Thefollowing muni OMg/maintenance records are kept for this feeitity©Aloun logs 490-69. 0 Visual Inspcotion Records 490-6s6 ❑Tank integrity testing results 491]-bac ❑SIR testing results(and supporting documentation records). 49-6ad ❑ Tank gauging results(and supporting docus). 4906 e❑ATO Testing results(and supporting documentation records).49aiaf ❑ Corrosion Protection 60-day logs 490-6ss®Equipment maintenance and calibration records. 49o.sahIX.TRAINING V Personnelwith UST monitoring responsibilities are familiar with all of the following documents relevant to theirjob d . REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) ❑� THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490-69h ❑Q OPERATING MANUALS FOR ELECTRONIC MONITORINGEQUIPMENT(Required)g9069e ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49o.sm ❑ CALDiORNIA UNDERGROUND STORAGE TANK LAW 49-69- ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: ..BAND FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"49oof ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"49a69g ❑ OTHER(Specify):hoign m69t This facility has a"Designated UST Operator"who has pasud Ute California UST System Operator Exam administered by the Intemational Code Comcil(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 wnsistent 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 ➢ 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 additional comments hem or indicate how many pages with additional information On specific monitoring procedures are attached to this plan.49-71 Audible and visual overfill alarm set a190%of tank capacity for overfill protection.See additional attachment. XL PERSONNEL RESPONSIBILITIES The UST Owner/Opemtor 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,said 3)all monitoring records are maintained properly. The following peraonre(s)aresponsible for performing the monitoring and equipment maintenance: NAME Tim Hurlocker g9an TtTLE Director of Gasoline Operations NAME Dennis Bock4M73 49-74 TITLE Environmental Compliance Manager 49-15 The Designated Operator shall perform a monthly visual inspection of the facility,provide a report to the owner/operator,and inform thtM6iiii pemtor of any conditions that need follow-up action. XH,OWNER/OPERATOR SIGNATURE f.^.. CERTIFICATION:I certify t the information provided herein is true and accurate to the best of my knowledge. APPL�AN'FSIGNATURE 490.]6 DATE: qy-]r Il r� APPLICANTNAME(print): 490'9- APPLICANT TITLE: 490'+9 David H Rogers C Director of Real Estate Development UPCF UST-D(12l20n 3!4 lit! Co9&fi`&�-A \' Z �I