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Jan, 27. 2010 6.30AM — No. 3418 P. 1 UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN (Page a of a) �' +.'"�`-rt.W��,r:� ;�TINDEI�DTSPF.L7•SER'SvOP1"AAV1F1Ef�'F MOIJITOWIYG- 1. UDC MONITORING IS PERFORMED USING TRR FOLLOWING METROD sass I.CONTINUOUS ELECTRONIC MONITORING ❑2.FLOAT AND CHAIN ASSEMBLY [33.ELECTRONIC STAND-ALONE ❑0.NO DISPENSERS ❑99.OTHER Sp cifyk PANEL MANUFACTURER: LEAK SENSOR MANUFACTURER-, acm Q aao-n MODEL g(S):L5- -��•— +vers DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS s.YES ❑b.NO wow UDC LEAK ALARM TRIOQERS AUTOMATIC PUMP SHUTDOWN �,'a YES ❑b-NO 49060, FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® A.YES ❑Is.NO .1 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. tK a YES ❑Is NO asrrm 1 UDC CONSTRUCTION IS W.SINGLE-WALLED (j 2.DOUBL&WALLED °9°v IF DOUBLE WALLED: snobs. UDC INTERSTITIAL SPACE IS MONITOMW BY: ❑I.LIQUID 2.PRESSURE EJ 3.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑s,YES VM stAab ❑ 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT EMiAN.M °sobs. _ ION BI.D MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS RHQUfREb. MCCR 2614.1 .®2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS, _ a9 3.SPILL BUCKET$ARE T151FED ANNUALLY. ...saq t =%s;:•,, t :�. "` M% , . :.i;.- ' Mr.,� '"',V.�IIIREC012DIC�EEPfNG ,llowing menitorinP/mxintcnanw records aro kept for this facility: um logs eso . Visual Inspection Records a.pbaa ❑Tank integrity testing resultsR tasting results(and supporting documentation mcords). a Nd ❑ Tank gauging results(and supporting documentation retards).O Testing results(and supporting documentation records).bsobtr ❑ Corrosion Protection 60-clay lags as..ata 19 Equipment maintortance and calibration mwrds. asobsn j.;m.. LlS TRA�1VIlYG Personnel with USTmanitmingrppons38itiea am familiar with all of the following documents relevant to lheirJob duties, aoasa Person DOCUMENTS MAINTAINED AT FACILTI'y(Check all that appy) ErTHIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required).sobw WIOPEPLATING MANUALS FOR ELECTRONIC MONTTORING EQUIPMENT(Required)aso.ax LJ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS ave w ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 4w% ❑ STATE WATER RESOURCE$ CONTROL BOARD (SWRCB) PUBLICATION; "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION",its w ❑ SWRCB PUBLICATION;"UNDERSTANDING AUTOMATICTANK GAUGING SYSTEMS"aso.aas ❑ OTHER(S,.w-4);M69n,.N6st is fer;lity has a"Designated UST Opmamr"who him penal this California UST System Operator Exam edminiatered by the Innemetional Code Council(ICL. The"Designated UST Operator"will train facility employers in the proper operation and maintenance of the UST systems enmully,and within 30 days of hire This training will include,but Is not limhcd to.the following D Opamtian of Lha UST ayatema in a manner fonsirtcn[vnth the faciliry'a beat m.nagcmant practices > The facility employee's rola with regard to the monhonng equipment as apecifind in this UST Monitoring Plan > The facility employ.'.rola with regard to spill.and overfills as specified in the UST Response Plan D Names of comet pmmm(4)for emergencies and monitoring alums.aaota Provide additional conuramts hero or indicia now many pages with additional iofematto,on specific monitoring P ate atfaehed to thug plan.exon fne:,a. ,"0 F1OPPes a5P'0 a a . XL P'ER3bNNEL ALIMNSiou I-11,[Tb5 no UST Oxeer/Opuetor is responsible for mviuring that;1)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment covered by this plan occurs,2)all conditions that indicate it possible release are investigated,and 3)all monitoring records ere malntnined property. The following persai(a)am responsible far performing the monitonhg and equipment maintenance NAME °son TITLE ^. r L r� anon NAME eso-ra TITLE 1assn no Designated Operator aaall perform a monthly visual inspection of the facility,provide a report to the owner/operator, and inform the owner/operator of any cmWitiona that need fellow-up action XIL OWNER(OPERATOR SIGNATURE CERTIFICATION:I certify that the infarmadon provided herein is we and accteate to the best of my knowledge. APPLICANTS A F asap DATE; assn APPLICANT NAME(print): °'acs APPLICANTTniE; aeon �eks iCy+4 �[�tG