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�NIF1ED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN P980201`2) VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD ® I.CONTINUOUS ELECTRONIC MONITORING ❑2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE ❑4.NO DISPENSERS ❑99.OTHER(Spcc )_ PANEL MANUFACTURER:V4eder Root(VR) 490.53 MODEL#:TLS-359R �fe. LEAK SENSOR MANUFACTURER:VR UDC Interior 49x31 MODEL O(S):794398.20! 4 0 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ® a.YES ❑b.NO 40'50 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ® a.YES ❑6.NO 140.60 FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑It.NO 4oe1 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER ® a.YES ❑b.NO 4oe2 2.UDCCONSMUCTIONIS ®LSINGLE-WALLED ❑2.DOUBLE-WALLED 40et IF DOUBLE WALLED: 49064. UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ L LIQUID ❑2.PRESSURE ❑3.VACUUM _ A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO 49064h VII.PERIODIC SYSTEM TESTIJNG 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCE 49045. FAL DETPrTION( a n)MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS!k (IJIRED.(23 CCR§2644.1) ®2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 40'66 1.SPILL BUCKETS ARE TESTED ANNUALLY. aaoal Vim.RECORDKEEPING The following monitoring/maintenance records ate kept for this facility: ®Alum logs 4v0-69e ®Visual Inspection Records 49o-661, ❑Tank integrity testing results 4w-6m ❑SIR testing results(and supporting documentation records). 404ed ❑ Tank gauging results(and supporting documentation recardst. 4a6se ❑ ATG"resting results land supporting documentation records).4we6sn ❑ Corrosion Protection loot-Jay logs 4a6sa ®Equipment maintenance and calibration records. 490. h IX.TRAINING ®Penornel with UST monitoring responsibilities are familiar with all of the following documents relevant to dteirjob duties. 40694 REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all thin apply) ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)4 % ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Requined14v0-ex ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 40a9d CALIFORNIA UNDERGROUND STORAGE TANK LAW 40-6% STATE WATER RESOURCES CONTROL BOARD (SWRCD) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION'4049r ❑ SWRCB PUBLICATION:-UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"4w.ra ❑ OTHER(SpecilYk w91 w9; Rg 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 mining will include,but is not limited to,the following: > Operation of the UST systems in a roomer conaistent with the fao:iliiy's beat management practices 'r The facility employee's role with regaN to the monitoring equipment as specified in this UST Monitoring Plan i The facility employee's mle with regard to spills and overfills as specified in the UST Res onvic Plan )o Names ofconuct personas)for emergencies and monitoring alarms.4valo X. COMMENTS/ADDITIONAL INFORMATION Provide additional comments hem or indicate how many pages with additional information on specific monitoring procedures am smelted to this plan.40-71 XI.PERSONNEL RESPONSIBILITIES The UST Owner'Opcnator is responsible for en unng that: 1)the daily/murine UST monitoring activities and maintenance of UST loss detection equipment covered by this plan occurs'.2)all conditions that indicate a possible release an investigated.and 3)all monitoring records arc maintained properly. The following person(s)are respoasible for performing the monitoring and equipment maintenance NAME ~2 TITLE 44 73 NAME 49a14 TITLE 490-75 The Designated Operator shall perfinm a monthly visual inspection of the facility, provide a report to the owner/operator,and inform the ownteNoperatm of any conditions that need follow-up action. XII.OWNEWOPERATOR SIGNATURE CERTIFICATION:1 certify that the information provided herein is true and accurate to the best ofmy knowledge. APPLICANT SKiNATU wa76 DATE: 40-n Feb.5,2010 4 APPLCANT NAME(prim): APPLICANT TITLE: s Bock Compliance Manager UPCF UST-D(1212007)3/4