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UIPIED PROGRAM CONSOLIDATED FORqp UNDERGROUND STORAGE TANK MONITORING PLAN — (Pae 2 of 2) ,:. (Checkoff VI. UNDER DISPENSER CONTAINMENT (UDC) MONITORING thata t UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) 49MU ❑ 1.CONTINUOUS ELECTRONIC MONITORING ® 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 49o-s4b. ❑ 4.NO DISPENSERS ❑ 99.OTHER(Specify) 490.66 490-56. LEAK MONITOR MANUFACTURER:Veeder-Root MODEL#:TLSoats 49057 MODEL#(S>:Floats and Chain 491-ss. LEAK SENSOR MANUFACTURER: OPW 490.59. DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. ❑ a.YES ® b.NO 490-6/. UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ® b.NO FAILURFIDISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ® b.NO °�� UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ® a.YES [I b.NO 490-62'490-65 UDC CONSTRUCTION IS: ® 1.SINGLE WALL ❑ 2.DOUBLE WALL 490.64-6 IF DOUBLE WALL: UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ a.LIQUID ❑ b.PRESSURE ❑ c.VACUUM 49x646 A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. 1:1a.YES ❑ b.NO VII. PERIODIC SYSTEM TESTING. CONTROL® 1 EEDK DETECTITNI ELDCMUST BE PERFORMED'PERIODIC ELD IS PERFORMEDEVERY 36 BOMONTHS AS REQUIRED.123 CR§—264ENHANCED 4.11 49-665. 4906. ® 2.SECONDARY CONTAINMEN'C COMPONENTS ARE TESTED EVERY 36 MONTFIS. 490-6a ® 3.SPILL BUCKETS ARE TESTED ANNUALLY. VIIL'`RECORD KEEPING 490-68. The following monimring/maintenance records arc kept for this facility: ® a.ALARM LOGS ❑ b.V4SUAL INSPECTION RECOOS ❑ c.TANK INTEGRITY TESTING RESULTS ❑ LTS(and supporting documentation records) f.ATG TESTING RESULTS(and supporting documentation records) C] g.CORROSION PROTECTION 60-DAY LOGS ® h EQUIPMENT MAINTENANCE AND CALIBRATION RECORDS "IX. TRAINING ® Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to theirjob duties: REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) 49M9b. E THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 9c 4966 ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) 490-69& ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490.690 ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND 49049f STATISTICAL INVENTORY RECONCILIATION" 490.696. C3SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 490-691. ❑ OTHER(Specify): 490-69L ® This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the Interoa[ional Code Council 490-70. (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. ➢ The facility employee's role with regard to spills and overfills as specified in the facility's UST Response Plan. ➢ Name(s)of contact person(s)for emergencies and monitoring alarms X. COMMENTS/ADDITIONAL IN Provide additional commrnLs here or indicate haw many pages with additional information on specific monitoring procedures are attached to this plan. 49-671. XI.YPERSONNEL RESPONSIBILITIES The UST Owner/Operator is responsible for ensuring that: 1.)the daily/routine UST monitoring activities and maintenance of n:j quipment covered b this plan occurs;2.)all conditions that indicate a possible release are investigated and 3)all monitoring records are maintaine ..,__,,.._,.___THE FOLLOWING PERSON(S)ARE RESPONSIBLE FOR PERFORMING THEMONITORING AND EQUIPMENT MAIN490 7a490-72. TITLE:Store Manager 490-75.NAME: Wendy RaneyNAME: George Sisson49074 TITLE:Zone Manager The Designated UST Operator shall perform a monthly visual inspection of the facility,provide a report[o the owner/operatorner/operator of any conditions that need follow-up action F:XIII OWNER/OPERATORSIGNATURE CERTIFICATION:I certif that a information rovided herein is true and accurate to the best of my knowledge. 490-77 APPLICANT SIGNATURE /J DATE: July 22, 2009 REPRESENDNG:®I.Tank O ff/ wr®2.Fecilit Ownal &tor (]3.AuthorizM R tarivc afOwkr 490-06.490-08" APPLICANT TITLE: 490-79. APPLICANT NAME(print): Paul Chevalier Maintenance Manager UPCF UST-D(12/2007)-3/4 www.unidocs.org