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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUNDSTORAGETANK MONITORING PLAN (Page 2 or 2) VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING Jfl-544 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-54x ❑ 1.CONTINUOUS ELECTRONIC MONITORING ®2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE ❑4.NO DISPENSERS ❑99.OTHER - -------- ---____-- r--_______. 641456. PANEL MANUFACTURER: °w.ss MODEL#: _.------_.-------_-- -------_ J911.5] a9P5x LEAK SENSOR MANUFACTURER:Bravo MODEL#(S):Float&chain DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑ a.YES ®b.NO w.w UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ❑ a.YES ®b.NO 4`M-60' FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YFS ®b.NO dw-61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ® a.YES ❑b.NO 4%462 awafi3 2.UDCCONSTRUCTIONIS ®I.SWGLE-WALLED 112.DOUBLE-WALLED IF DOUBLE WALLED: UDC INTERSPACE IS MONITORED BY:.❑1.LIQUID ❑2.PRESSURE_❑3.VACUUM __—_ ._--_____—__-_---_- ___-__ _INTERSTITIAL -- A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO 4f061h VII.PERIODIC SYSTEM TESTING L ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL ROARD THAT EMiANM 49a6b. LEAK DETF-CTION(ELDI MUST BE PERFORMED_PERIODIC ED IS PERFORMED EVERY 36 MONTHS AS REQUIRE (23D. CCR¢2644p_ _________ _- J90-M ®2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS., __--- _____ ______— _--_-__----_ 3.SPILL BUCICEIS ARE TESTED ARr ALLY. 4fa6] VIII.RECORDKEEPING The following monitoring/maintenance records are kept for this facility: ®Alarm logs cw.ma ❑Visual Inspection Records 4wi-mb ❑Tank integrity testing results 49(a6xc ❑SIR testing results(and supporting documentation records). 4vt and ❑ Tank gauging results(and supporting documentation records). Jw-bw< ®ATG Testing mulls(and supporting documentation records).awifisr ❑ Corrosion Protection 60-day logs Jwrxg ®Equipment maintenance and calibration records. 4vo-mb IX.TRAINING ®Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to theirjob duties. 4f % REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)Jf1-69 ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)swlmn ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490a69d ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW Nfa6* ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"4fa69r ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490 69g ❑ OTHER(Specify):M691a M6% 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: D 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.4911-70 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.490-71 ntc(iilhemo waiks He ddvcr a1 vin of lank capacay with M CXLCMl Lam aid Hgk. XL 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 person(s)are responsible for performing the monitoring and equipment maintenance: aw-D NAME Ja mr Gill aw-n TITLE Manager NAME Don Marceiti 490.74 TITLE Area Manager 49()-75 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.OWNER/OPERATOR SIGNATURE CERTIFICATION:1 certify information that the infoation provided herein is true and accurate to the best of m 7 knowled e. J9n APPLICANT SIGNATURE I ' 4wa76 DATE. a9n.]s afan9 APPLICANT NAME(print): APPLICANT TITLE: Sandy Huff Compliance Coordinator UPCF UST-D(122007)3/4