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Now UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VI.UNDER DISPENSER CONTAINMENT(UyC)DMONITORING 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD �V o 4y34 J ❑ 1.CONTINUOUS ELECTRONIC MONITORING 10 2.FLOAT AND CHAIN ASSEMBLY 3.ELECTRONIC STAND-ALONE ❑4.NO DISPENSERS 1199.OTHER(S i ): PANEL MANUFACTURER: 49o-35 1 MODEL#: 490'56, LEAK SENSOR MANUFACTURER 49LL59 1 MODEL#(S): 4 311 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑ n YES ❑b.NO 44o-59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ❑ a YES ❑b.NO 49060. FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑b.NO °90.61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER ❑ a.YES ❑b.NO 4s 2.UDC CONSTRUCTION IS (91.SINGLE-WALLED ❑2.DOUBLE-WALLED ° IF DOUBLE WALLED: 4904 UDC INTERSTITIAL SPACE IS MONITORED BY: Q 1.LIQUID 2.PRESSURE Q 3.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a YES ❑b.NO 4so6u VII.PERIODIC SYSTEM TESTING 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65. (DEFECTION(ELD)MUST BE PERFORMED, PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS RE UIRED. 23 CCR 2644.1 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 49066 3.SPILL BUCKETS ARE TESTED ANNUALLY. 490c7 VIII.RECORDKEEPING The following monitonng/maintenance records are kept for this facility: ®Alarm logs 4sa694 ❑Visual Inspection Records 45 b ❑Tank integrity testing results 4v k ❑SIR testing results(and supporting documentation records). 4soss4 ❑ Tank gauging results(and supporting documentation records). 44 80 ❑ATG Testing results(and supporting documentation records).4saeer ❑ Corrosion Protection 60-day logs 4m.eas ❑Equipment maintenance and calibration records. 4so.6sb IX.TRAINING ®Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 490.6s4 REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN( uired)4w % OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)4v sft CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490.666 ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 4so4n4 ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"4s06sr ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"4v ft ❑ OTHER(Specify):s464n.sisvi gg 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 D 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 alums.46°70 X. COMMENTS/ADDFFIONAL INFORMATION Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures areattached to this plan.4so.rt JUCr �c4ior� IP 4- Qrf q4- C ' XI.PERSONNEL RESPONSERIUTIES The UST Owner/Operatm is responsible for ensuring that:1)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment cov l this plan occurs,2)all conditions that indicate a possible release are investigated,and 3)all monitoring records are maintained properly. The followjng persons)are«sponsible for performing the monitoring and equipment maintenance: NAME 7 SST 4s 72 TRLE 'y^C 44�74 NAME4so-r4 TITLE 490-75 The Designated Operator shell perform a monthly visual inspection of the facility, provide a report to the owner/operator, and inform the owner/operator of any conditions thin need follow-up action. XII.OWNER/OPERATOR SIGNATURE CERTIFICATION:I cai that the information Provided herein is true and accurate to the best of my knowledge. APPLICANT SIGNATURE / 490-16 DATE: 4w77 MFRtSWT_ 1 Ox IOoI�+ ❑I AA APPLICANT NAME(print)' i90'6 APPLICANT TITLE: 419 SwlC"'�q if R SIXVI 4 O l-�/✓��? LPCF UST-D(1212007)3/4