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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK APR 2 , 2012 MONITORING PLAN (Page 2 of 2) VI.UNDER DISPENSER CONTAINMENT(UDC)MONITO I. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD f NCYSER�lp�90. ® 1.CONTINUOUS ELECTRONIC MONITORING [12.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE ❑4.NO DISPENSERS ❑99.OTHER(Specify): PANEL MANUFACTURER:VEEDER ROOT 690.39 MODEL#:TLS-350 490-56. LEAK SENSOR MANUFACTURER:VEEDER ROOT 4905' MODEL#(S):794380.208 490.58 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ® a.YES ❑b.NO 40-59 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 49P61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ® a YES ❑b.NO 49062 2.UDC CONSTRUCTION IS ®l.SINGLE-WALLED ❑2.DOUBLE-WALLED 490-63 IF DOUBLE WALLED: 4o44e UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ 1.LIQUID ❑2.PRESSURE ❑3.VACUUM __ A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO 4W-64b- VII.PERIODIC SYSTEM TESTING ❑ 1. 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. 49066 ®3.SPELL BUCKETS ARE TESTED ANNUALLY.----------- --- ------ 490-67 VIII.RECORDKEEPING The following monitoring/maintenance records are kept for this facility: ®Alarm logs 4W68a ❑Visual Inspection Records 490.686 ❑Tank integrity testing results 406k ❑SIR testing results(and supporting documentation records). 4WW ❑ Tank gauging results(and supporting documentation records). 49o-a8 ❑ATG Testing results(and supporting documentation records).49068f ❑ Corrosion Protection 60-day logs 4o-68g N Equipment maintenance and calibration records. 49068h LX.TRAINING N Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to theirjob duties. 49a69e REFERENCE DOCUMENTS MAINTAINED AT FACILITY=(Check all that apply) ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490696 ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)40-6% ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 40-6w ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 49P69e ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"49o-69r ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490-698 ❑ OII ER(Specify):M694 m69i This facility has a"Designated UST Operator"who has passed the California USE 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 USE systems in a manner consistent with the facility's best management practices ➢ The facility employee's role with regard in 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.49a7o X. COMMENTSIADDITIONAL INFORMATION Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan.49071 THE OVERFILL PREVENTION METHOD IS EXTERNAL AUDIOVISUAL ALARM SET AT 90% OF TANK CAPACITY. XI.PERSONNEL RESPONSIBILITIES The UST Owner/Operator is responsible for ensuring that: l)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 persons)are responsible for performing the monitoring and equipment maintenance: NAME DENNIS BOCK 490-72 TITLE COMPLIANCE MANAGER 49x73 NAME TIM HURLOCKER TITLE DIRECTOR OF GASOLINE OPERATIONS 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:I certify that the information provided herein is true and accurate to the best of my knowledge. APPLICANT SIGNATURE . 49076 DATE: �f 490-77 ❑ or 02.Fac'lir H -ed Re resentaiv of Ow APPLICANT NAME(print): 19678 APPLICANT TITLE: 490-79 DENNIS BOCK COMPLIANCE MANAGER Belshire Environmental Services,Inc.