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