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IED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VI. UNDERDISPENSER CONTAINMENT(UDC) MONITORING 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-s4a 490-546 ❑ I.CONTINUOUS ELECTRONIC MONITORING E 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE ❑ 4.NO DISPENSERS [199_OTHER(Specify)___...__...... ,-_-._-_--_- ---- PANEL MANUFACTURER: 490ss MODEL#: 49056. _ ___-_-.._.._-_._—___._.._.___________________.__._--._.._--_--__-_-_-_�-- _ ...___.--____-____..___-_____- 490-38 _____-_-_.__--_-__—_---- 490-57 LEAK SENSOR MANUFACTURER: MODEL#(S): DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS a YES b.NO 49039 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 Pf b.NO 490.61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. a.YES ❑b.NO 49 2 2.UDC CONSTRUCTION IS ❑I.SINGLE-WALLED ❑2.DOUBLE-WALLED 490-63 IF DOUBLE WALLED: 446: a UDCINTERSTITIALSPACE IS MONITORED BY: [)_LIQUID _❑2.PRESSURE El 33.VACUUM A LEAK WITHIN THE SECONDARY,CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ,R.YES ❑b.NO 490-641, VII.PERIODIC SYSTEM TESTING I. 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 REQU]RED_(23 CCR X2644_1)___.-- E 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. _ — ----.___--__ --------------------__T-------------------______---__.. __------- _-_-----_4 3.SPILL BUCKETS ARE TESTED ANNUALLY. 490fi7 VIII.RECORDKEEPING The following monaming/maxttenance records are kept for this facility. E Alarm logs 49 8. {��75+,Visual Inspection Records 490681, ".Tank integrity testing results 49 8L ❑SIR testing results(and supporting documentation records). 49o-b8d ❑ Tank gauging results(and supporting documentation records). 49aaae ❑ATG Testing results(and supporting documentation records).4906af ❑ Corrosion Protection 60-day logs 490.6ag ® Equipment maintenance and calibration records. 490.68h IX.TRAINING E Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to theirjob duties. 49069. REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) . E THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)49669b E OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490b9c ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 49 % ❑ 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"490-690 ❑ OTHER(Specify):m694 moi This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council HCC). 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.490-70 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 oft it rev¢aI�'� oT rnaeAadtA4� Fja rd Set at- �Sa XI.PERSONNEL RE NSIBMITIES The UST Owner/Operator is responsible for ensuring that t)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: NAME ALEX JABBARI 490.72 TITLE DESIGNATED UST OPERATOR 490-73 NAME 490-74 TITLE 490-75 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 fol)ft-up action. XII.OWNER/OPERATOR SIGNATURE CERTIFICATION: certify that the i formlition provided herein is true and accurate to the best of my knowledge. APPLICANT SIGN E 490-76 DATE: 490.77 Fa i1i d APPLICANT NAME(print): 490-78 APPLICANT TITLE: 90079 Rupinder Padda SEC.