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III 111 UNIFIED PROGRAM CONSO1111'LIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN—(Page 2 of 2) VI. UNDER DISPENSER CONTAINMENT(UDC)MONITORING (Checkall UDC MONITORING IS PERFORMED USING THE FOLLOWING METHODS) X 1.CONTINUOUS ELECTRONIC MONITORING rhar o 1 ❑-4.NO DISPENSERS ❑ 2.FLOAT AND CHAIN ASSEMBLY __._____.__ _ .__.-.____. 99.__.__ ❑ 3.ELECTRONIC STANDALONE 490.34. LEAK MONITOR MANUFACTURER:Veede❑r Root ER(Specify) 490.55 490.346 LEAK SENSOR MANUFACTURER:Veeder Root 4so-sJ MODEL a: )'IV4j 4911 DETECTION OF p LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS, MODEL q(S):7943$0-ZQg 4so-se. UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN. X a YES ❑ b.NO 4W 59. FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. X a YES ❑ 1 NO 490.6a UDC MONITORING STOPS PS THE FLOW OF PRODUCT AT THE DISPENSER ❑ b.NO 4901 -DCCO__________ _ UDC CONSTRUCTION IS - X 1.SINGLE WALL "-- X e YES 4906a. IF DOUBLE WA t. ❑ 2.DOUBLE WALL ---- -�--- UDC INTERSTITIAL SPACE IS MONITORED BY: QUID 4�3 A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE bA D VISUAL ALARMS. ❑ a YES 4s 1, ❑ c.VACUUM VII. PERIODIC—SYS TEM TESTING ❑ b.NO I.F,LD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED MUS"f BE PERFORMED. PERIODIC ELcca a uD IS PERFORMED EVERY 36 MONTHS AS REQUIRED i i 49oas ® 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. ® 3.SPILL BUCKETS ARE TESTED ANNUALLY. 490.66 VIII. 490.67. The following monitonng/maintenance records are kept for this facility:RECORD KEEPING ® a.ALARM LOGS ❑ b.VISUAL INSPECTION RECORDS ❑ d.SIR TESTING RESULTS end su g ❑ c.TANK INTEGRITY TESTING RESULTS 490,u ( pportin documentation records) ❑ C.TANK GAUGING RESULTS end supporting❑ f ATG TESTING RESULTS(and supporting documentatlon records) ❑ ® h-E UIPMENT MAINTENANCE AND CALIBRATION RECORDS g'CORROSION PROTECTION 60-DAY LOGS Personnel documentation records) Personnel with UST monitoring responsibilities are familiar with alllo�theTRAININGnts relevant[o theirjob duties: REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check al(rha apply) ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN 49 ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) EJ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490y96 ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 4901 CONTROL BOARD ❑ STATE WATER RESOURCES 40.6gt. (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND 490p9r STATISTICAL INVENTORY RECONCR,IATION' ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 13 OTHER(Specify): 490698. This facility has a"Designated UST 490697. (ICC). The "Designated UST Operator"wha has passed the Califomis Up5T Stem Operator Exam administered by the International Code Council 494�0-'M. 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 rrot 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 INFORMATION Provide additial commen onts here or indicate how many pages with additional information on specific monitoring rocedures The overfill navention device Is a CNI dro tube and all Boats stem whieh Is set at 90h to sto Atha Bow fuel ched to thisdelpan. 4�7 XI. PERSONNEL RESPONSIBILITIES The UST Owner/Operator is responsible for ensuring that: 1.)the daily/routine UST monitoring activities Maurice of UST leak detection equipment covered by this Elan pce_"rs.�ell conditmns that indicate a posst6le release are investigated.and 3.)all monitoring records are maintained proper , —THE FOLLOWING PERSON(S)ARE RESPONSIBLE FOR PERFORMING THE MONITORING AND EQUIPMENT MAINTENANCE NAME: Mona Perez 490-72 TITLE:_Manager 4901 NAME: Band Edwards 490.74. TITLE Environmental Com (lance Admin. 49 75 The Designated UST Operator shall perform a monthly visual inspection of the facili conditions that need follow-upaction. ty,provide a report to the owner/opermor,and inform the owner/operator of any XII. OWNER/OPERATOR SIGNATURE APPLICANT SIGNATU CERTIFICATION:L cert I that the information rovided herein is true and accurate to the best of as knowled e. DATE: 490.7 141 8/3/09 aEPaPaaM1A'G:X I.Ink Omr i.F 'I' 1.N,apvd R iw OrQMI1R 4901 UPCF UST-D(122007)-4r0 www.unidoes.org