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JUN-10-2010 12 :27 PM P_ 04
<br /> UNIFIED PROGRAM CONSOLIDATED FORM
<br /> UNDERGROUNDSTORAGF,TANK
<br /> MONITORINGPLAN (Page2of2)
<br /> _ —RPORMF..D USING-rHE FOLLOWING METHOD 4%.5Ae
<br /> aw•sAb
<br /> 1.CONTINUOUS It.1.,EC'rRONIC MONITORING ❑ 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STANDALONE
<br /> 4.N0 .)I_SI IiVSER_5_-_- �_9L OIHE f � 0 ----------- 'MODCLa:_ --'
<br /> uEtL(.ICON 0;A LEnK IN70'rHG UDc'I'RIGGERS AUDIDLE ANO vISUAI.ALARMS a.YEST❑b - ssa-ns
<br /> PANUI.MANUFACTURER! a0� _^�_.-- _ _�__ � .... N�..___.
<br /> LEAK SEN.6UR MANLIFACT'L1Rl'iR (��, �� �- "��� sw-ss
<br /> ._ __.. ..__..__._.. O Lop-ia
<br /> UDC I.F:AK ALARM TRIO0FR5 At ITOMATIC PUMP SHUTDOWN Mo.YES ❑b.NO
<br /> FAII A!RF./DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PCI MP SHUTDOWN. (2(p.YES ❑b,NO
<br /> UDC MONf ('MIN(i STOPS THP.FLOW OF PkODUCI'AT THF. DISPENSER. FEL YES ❑b.NO wo-62
<br /> 2.1H)CI CONSTRUC11ON IS %L SINGLE-WAI.I.FD L.:2.lx)UBL&WALLED ---_ a9os9
<br /> ___... _.. .. _.._—.................. . .... _..__.__-...._._ ----
<br /> IF DOC B!.):WALLED: 19pfi°"
<br /> I1DC!NTERS'1'IIIAL.SPACE IS MONITOkr.D BY: 1.LI-Illt) _ 2.PRP.SSIIRE ].VACUUM __ -_
<br /> A LF„\K W I NI1N rHE t(F('.OigliAAN (.ON'I'AINMEN'r OP THF UJOC TRIGGERS AUDIBLE AND VISUAI.ALARMS ❑e.YES ❑Ir,NO
<br /> VII.PERIODIC SYSTEM TESTING
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<br /> L KL!) 1 h:ST ihitir'. 'FILLS I'ACIL.ITY HAS RF.FN NOTIFIED 8Y THF. FI-ATF WAfkk RESOURCES CONTROL BOARD'THAT FNIIeNSRn
<br /> I•F.n O"I ;(."( O ° L) M11SI'D 'I tiRFf1R_M_IiD. PERIODIC Fi_I.D IS PERFORMED EVERY 36 MONTHS AS REQUIRED.(23 CCR$3644.1) •„`
<br /> Lq2,_SFA_:O_N:b1R_1'l':UNTAIN3IEN'I'COM_PONRNTS ARE TESTED FVF,RY 36 MONTHS -•�, —_ __-__��
<br /> 39V11.L,Oli(K!'sfGANF.Ti?CTN:FI A11Nl!A1.LV. �------ ---- .soar
<br /> VIII_.RECORDKEEPING
<br /> WTh�follawhlg 11100"ringhoal mance rxurds arc kept for thu Pociliry. -- —-- ---- — --
<br /> $Alarm hoz: c1•er. Coal h•spectio.t Retards 4vo.65n O'F k integrity Testing results.mr.wc
<br /> 0,$IR t%ling.rksk,!Is(and suoportin.g documentation words). "w ,%d hIYI Ink gauging results(and supporting documentation reoortt9). <9a•6te
<br /> Lel ATO fond sone orlino d•v ninentaNrm record%).wu ,isr ❑ Corrosion Protection 6(May Ings aw,asa
<br /> 'Equipmrnl moin!ere"re and nalibmA,o, ma.d,. .90 nth
<br /> ----- — ---� _ IX-TRAINING
<br /> Perynnnel with 11S'1'menlloring responsib+litics are fam!li.➢ with nil ofthc following documents relevant to lheirjoh duties. A9
<br /> RI'.FERil 401-(IMENTS MAINTAINET)AT FACILITY(Check all that apply)
<br /> dTtt(S VNi)VTOROUND STORAGE TANK MONITORING PLAN(Required)mn.esh
<br /> ripe 'r!N(,1 MANIIAI ti FON F.LFC'1'RONI(:MONITORING EQUIPMENT(Required)s9o.
<br /> n
<br /> CALIf•ORNIA IINDFROR(,IUND S'FOR.AGE TANK RFGULA Pwn69
<br /> IONS a
<br /> C,i.L11 IWN1.1(INI'llilt(,iri(IiIhU 3 iIJAA(iZTANK LAW 49a %
<br /> ffeINI'KI-E WATER RUSOURCI.-S C )NTY.01, BOARD (SWRCB) PUBLICATION; "HANDBOOK FOR TANK OWNERS MANUAI. AND
<br /> -iSrI.AIINVLiM'!'OR'i� RT(CONCII.IATION"49M169r S%k Rt'H Pt IBLIC7Cr10N:'-11NDERS rANDING AUTOMATIC TANK GAUGING SYSTEMS"496-e9R
<br /> JQ (il'Hi.R tSpecily):M69h,MA
<br /> 'Phis I':u+�liP:F.s t'liesiquutcd I IST Oneralor'who hes passed the CaliPornia UST'System Operator Exam administered by the ImcrruHanal Code Cowcil(ICC).
<br /> 'Ing"Oerlyur a 1!,IOperator”will Iain hxdily empinvens in the Proper operation and maintenance of the UST system annually,and within 30 days of hire This
<br /> training.YI 1 ilcl;dL••.LIId is tiny li n.wd to,I`✓:foilown:g'.
<br /> > Opr:eiot o("I:I IA'I'sysrenlc Ar I. ,rt.nr.cr corsistent with the fnciliry's hest management practices
<br /> > Tlx:fac:Tity umployec's rule with rcgtud Io rho mnnitnring equipment as specified in this UST Monitoring Plan
<br /> > The t1no711ty employes s rot,:with mgard to spills and nverlills as specitiud in the UST Response Plan
<br /> > Nn.V.i l(�Pat.'1[Aa'!,a•q':i 1.1r zinngm_.tica nlld Ialin11l6Mg alarmR�4M" .— --
<br /> .� ...._. _..._...._.___._ ..... _— .--_._ ...
<br /> X. COMMENTS/ADDITIONAL INFORMATION
<br /> Hm'ide uJJilia:u.�::�+Tn:ncnM litre nr mwcale Lnw nia-ny!mges'.vir
<br /> / h additional infpon�natinn nn specific monitoring procedures ere elleched to this Plan.a90-A
<br /> ---- -------------- ---- XI.PERSONNEL RESPONSIBILITIES
<br /> TI'e VST i N�:..c'p rcallnr iR rcapnnyi!rl:fla crosudng that: 1)the daily/routine UST monitoring activities and maintenance of US'r leak detection equipment covered by
<br /> this plan.,;+u.: .'. „aditiutm Ilial icdirstc r,nus6:hlc relmsc are invasiigatod,and 3)all monitoring records are maintained properly
<br /> The li611Mv'nc p:^!'on;s'aro re*;I hl;tta cn6:nni•,q mm monitoring and equipment Ina intenapen PN a9a97
<br /> NAME. A SOLE ,w-n 7TTLF 'MNA
<br /> IlIC—_._...._. ._...._._._.._._..__._—.�--
<br /> NAME ro.'!A III rI.E a90'r
<br /> The I.1es'.:gralt,l:)lrzls`.iv'3hsII ;r.:rti:r,I a nw1 thh risuul inspection of Ina facty. provide u report to the owner/operetor,and inform the Owrror/nperatot of any
<br /> corditiol:: ie :.;xi
<br /> _ Y.II.OINNER/OQERATORSIGNATURE
<br /> CERT!)'Cs•f!t)ti I rxtit , ha_dn:-in fc:_naPon provided herein is true and accurate to the best of my knowledge.
<br /> APPL.ICA-1'[;( 4 7 DAT'F:. asd:.n
<br /> akINLGLLxLI,.",%Ls ty_l rt.k.bl.9R![L1➢MamLLL)_Ep�l!J U,L s •..:n.,....,.row:.: !� r`U
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<br /> APP
<br /> L.--�^�'.,,.,.-,� rCf APPLICANT TITLE:-.:n11: ...
<br /> I1PUF Ut" ^(:. !Aly')3/4
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