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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORINGPLAN (Page2of2) VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING ' 1. UDC MONITORING IS PERFORMED USING'1'HE FOLLOWING METHOD 110-54' 49o-54b ❑ L CONTINUOUS ELECTRONIC MONITORING 012.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 4.NO DISPENSERS ❑99.OTHER(Specify): _ L MANUFACTURER:13reVC _--_ 49ws MODEL 49n-ss. LEA SENSOR MANUFACTURER: 490'31 MODEL#(S): 49asa DETEbKION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS a YES [I Is.NO d9e'ag UDC LEA ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN a.YES ®b.NO 49060. FAILURE/D CONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDO ❑ a YES ®b.NO 490"1 UDC MONITORG STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ® a.YES ❑b.NO 4w.e2 2.UDC CONSTR1jCTjbk4 IS b111.SINGLE-WALLED ❑2.DOUBLE-WALLED 495:0 IF DOUIILE WALLE 49564. IJDC INTERSTITIAL SP E IS MONITORED BY: ❑L LIQUID []_2 PRESSURE 3.VACJd f _ A LEAK WITHIN THESE NDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARkIs ❑a.YES ❑b NO °90646 VII.PERIODIC SYSTEM TES G 1. ELD TESTING TWS FACIL HAS BEEN NOTIFIED BY THE STATE WATERRESOURCES CONTROL BOARD THAT ENHANCED 410.6s L MUST PERFORMED. PERIODIC ELD IS PERFO _EVERY 36 MONTHS AS REQUIRED, 2( 3 CCR§2644. ®2.SECONDARY CON_T_AINMENT CO PONENTS ARE TESTED EVERY 36 MOPFIERS. ;95-56, ®3.SPILL BCCKETS ARE TESTED ANN LY. 4•)0-L1 ,(-e c YIII:R_E_co_ EYING The following monitoring/maintenanee records are kept this facility' _ I�Alarm logs 490e8• M Visual Inspection Records 4 ab ❑Tank integrity testing results 4 dsc ❑SIR testing results(and supposing documentation records 4soaad ❑❑ ,pfik gauging results(and supporting documentation records). 4906ee ❑ATG Testing results(and supporting documentation records:49"I f ❑ orresion Protection 60-day logs 4906ss ®Equipment maintenance and calibration records. 490681, IX.TRAINING -- ❑Personnel with UST monitoring responsibilities are familiar wi all of the following documents relevant to theirjob dunes. 49m% REFERENCE DOCUMENTS MAINTAINED AT FACT TY(C k all that apply) IIB THIS UNDERGROUND STORAGE TANK MONIT G PLAN Requved)490.d9b ® OPERATING MANUALS FOR ELECTROMC M ITORING EQ MINT(Required)4906x ❑ CALIFORNIA UNDERGROUND STORAGE T REGULATIONS d ❑ CALIFORNIA UNDERGROUND STORAGE ANK LAW sso69. ❑ STATE WATER RESOURCES CONTRO BOARD (SWRCat PUBL ATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONC IATION'49069f ❑ SWRCB PUBLICATION:"UNDERST ING AUTOMATIC TANK GAU G SYSTEMS"490-s9s ElOTHER(Specify):mob,w This facility has a"Designated UST 01,911mae,who has passed the California UST Sys Operator Exam administered by the International Code Council(ICC). The"Designated UST Operator'/ith ecility employees in the proper operation and . finance of the UST systems annually,and within 30 days of hire.This training will include,but is not lifollowing: > Operation of the UST systnner consistent with the fecility's best management dces > The facility employee's rord m the monitoring equipment as specified in this U MZoaring Plan > The facility employee's rord to spills and overfills as specified to the UST Respo Plan > Names of contact personsncies and monitoring alarms.490-10 X. COMMENTS/ADDITIONAL INFORMATION Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan.49o-71 Overfill Prevention=drop tube with mechanical flapper set at 95%. XL PERSONNEL RESPONSIBILITIES The UST Owner/ Aerator is responsible for ensuring that:1)the daily/routine UST monitoring activities and mainten' cc of UST leak detection equipment covered by this plan occurs )all conditions that indicate a possible release are investigated,and 3)all monitoring records are mei fined property. The followi I rson(s)are responsible for performing the monitoring and equipment maintenance: NAME MI a Eliason 490-1- TITLE Cardlock Manaler a95-n NAME Amos Abbott 4s0.14 TITLE Site Technician 49o-75 m The De noted Operator shall pertorm a onthly visual inspection of the facility, provide a report to the owner/opemm and inform the owner/operator of any candiC ns that need Collow-up action. 'XII.OWNERIOPERATORSIGNATURE Zi C/ERTIFICATION:I certify that the information provided herein is true and accurate to the hest of my knowledge. APPLICANT SIGNATURE 49o7s DATE: 410.71 311112009 a.,Q z APPLICANT NAME(print): 490-96 APPLICANT TITLE: 490.79 Mike Eliason Cardlock Manager UPCF UST-D(12/2007)3/4