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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING r � 1.�UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-54aa" 1.CONTINUOUS ELECTRONIC MONITORING490.546 ❑ 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE ❑4.NO DISPENSERS E199.OTHER(S ify): PANEL MANUFACTURER: Vos Yr /,j 09a'SD MODEL#: .}y4956. LEAK SENSOR MANUFACTURER: Ve4dey 490-s9 MODEL#(S): L(j " r49o-sa DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS R'a YES ❑b.NO 490'59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN `❑'a.YES [Ib.NO 490-60 E FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. a.YES [3 b.NO 490-61 UDC MONITORING STOPS T FLOW OF PRODUCT AT THE DISPENSER. ❑ a.YES C]b.NO 490.62 2.UDC CONSTRUCTION IS L SINGLE-WALLED ❑2.DOUBLE-WALLED 490-63 IF DOUBLE WALLED: a9a64a UDC INTERSTITIAL SPACE IS MONITORED BY: I.LIQUID 2.PRESSURE [13.VACUUM _ A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO 4W b VII.PERIODIC SYSTEM TESTING I. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 49065. LEAK DETECTION ELD 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.SPILL BUCKETS ARE TESTED ANNUALLY. 490-62 VIII.RECORDKEEPING Th following monitoring/ndntenance records are kept for this facility: Alarm logs 4w. 1 Visual Inspection Records 490-6ab ❑Tank integrity testing results 490.6ec ❑SIR testing results(and supporting documentation records). 41 o 6$d ❑ Tank gauging results(and supporting documentation records). 490-68a ❑ATG Testing results(and supporting documentation records).490fiar ❑ Corrosion Protection 60-day logs 49 sag ❑Equipment maintenance and calibration records. 4srw8h IX.TRAINING Et Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to theirjob duties. 490s9a REFEU90-696 NCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) HIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)4 OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490.69c ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 4W4%i ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 4Wo 9e ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"490.69r ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"4v0fivg ❑ OTHER(Specify):M69h.M69i 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 ➢ 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.49620 X. COMMENTS/ADDITIONAL INFORMATION Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan.49621 Arejl p4es v;7AMec'L9N+cA � / /Tj7Ar✓ fe> /f 1`d % 2 u- v r r ' i/iA /V^^A< re ie-/e,.a M.PERSONNEL RESPONSIBILITIES The UST Owne Operator is res nsible for ensuring that: 1)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment covered by this plan ceca 21 c that indicate a possible release are investigated,and 3)all monitoring records are maintained properly. The followin responsible for perfo¢nung the monitoring and equipment mai nonce: NAME /.4.r.I— 4v62z TITLE c [t -e- 490.23 NAME ,�— 4v624 TITLE 490-25 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. 3UL OWNER/OPERATOR SIGNATURE CERTIFICATION:I certi ha the information provided herein is true and accurate to the best of my knowledge. APPLICANT SIGN490-76 DATE: 49673 FLEPRESEWn rl 2.F dm w7)r/ rar r 3.Au h ri 4./: J//� `V APPLICANT NAME(print) 49079 APPLICANTTITLE: 49029 r C+ v//— ry.y t •' UPCF UST-D(12/2007)3/4