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'NIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUA'a STORAGE TANK <br /> MONITORING PLAN (Page 2 of 2) <br /> T,. <br /> 777 <br /> 1. UDC MONITORING IS PERFORWD USING THE FOLLOWING METHOD <br /> 1.CONTINUOUS ELECTRONIC MONITORING (j 2.FLOAT ANO CHAIN ASSEMBLI' Q 3.ELECTRONIC STt ND•ALOW <br /> 4.NODISPENSERS 99.OTHER(S 1 a9a1f <br /> LEAK 4110-% <br /> vl�Cr00 osaPANEL MANUFACTURER: D57 <br /> ODELa <br /> SENSOR MANUFACTURER: V"t-� er ikoo . <br /> MODEL a(s). <br /> U11 <br /> b.No4ro•>+ <br /> DE IEC•TTON OF A LEAK WTUF THE UDC TRIGGERS AVDIBLE AND YASUAL-ALARMS b,NOUDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN FAILUREIDISCONNECTIONOFUDCMONITORING SYSTEMTRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑b.No <br /> nee? <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. 49W <br /> 2.UDC CONSMUCTRNN IS ).SINOLF-WALLED ❑2.DOUBLE-WALLED <br /> IF DOUBLE WALLED: <br /> UDC D!'lERSTITIAL SPACE IS MONITORED BY 1.LSUID—J-12. SURE ❑3.VACUUM _ 4N" <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS [}/c YES ❑b 470 Try <br /> 1 ELD TESTING: THIS FACILF" HAS BEEN NOTIFIED BY THE STA"1'E WATER RESOfIR'CFS I lH2Of.lIOARD THAT <br /> _ c ECTTO a(ELDI MUST BE PERFORMED PERIODIC EI.D 15 PERFORMED EV ERY 36 MONTHS AS UiRIsT). 23 CCR 2(vtN.l <br /> 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS <br /> no-a <br /> 3 SPILL BUCIf3E•I5 ARE TESTED ANNUALLY. <br /> The following monitoring/ meronue records we kept for this facunr <br /> Alarm logs rvoba <br /> visual Inspection Records noon ❑Tank integrity testing results no� <br /> SIR Mating renilts(and Supporting dom <br /> cuenowion records). n ❑ Tank paugmg results(aid supporting documemauon,umda). noaaa <br /> ❑ATG Testing results(and supporting documentation records).4o f [I Corrosion Protection 60-day logs mats <br /> oMowmatnhr mid calrbrauca rarords aswaab <br /> ❑Ikraoruml vNtnUST nnonNoring raponnTOttia are 9innlicwuh tll of the Buttoning docsmtanbrdavaat glhac job dnuas. 490691 <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check au that apply) <br /> THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)asassa <br /> OPERATINMAUNNUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)hoax <br /> I ❑ CALIFORNIAGDERGROUND STORAGE TANK REGULATIONS ssaeta <br /> CALIFORNIA UNDERGROUND STORAGE TANK LAW noes. <br /> ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS MANUAL AND <br /> STATISTICAL INVENTORY RECONCILIATION"aso-svn' <br /> 0 S WRC8 pVB2:ICA7WN:"UNDERSTANDING AUTOMA nC TANK GAUGING SYSTEMS"ssotta <br /> [] OTHER(Specify):atria,sawi <br /> This facility las a"Daigroled UST Operator"who hes Passed the Califomie UST System Optruor Exerri administered Try the limit I tional Code Council(ICC). <br /> "Desigmiad UST Operator'will train factliry employee in[he proper operation aril mainlerrmncc of the UST systems annually,and wNhin 30 days of hue.This <br /> training will include,but is not limi4d to,the following-. <br /> D Oyeretion of the UST systems in a manner consistent with the facility's best managemrnt practices <br /> > The facility employee's role coati regard m the monitoring equipmrnt as specified in this[NST Monitoring P(en <br /> Y The facility employee's role with regard to spills and ove�lls az specified in the UST Response Plan <br /> D Namea of nwMacl pusoit(s)for emeiguncie and montorirng alarms.no-7o _ <br /> Pravda eddita7rod Aero or rrdreaae Aawmv+y pwges witlbaddmoml information on specific monitoring procedures are auaelwd to this plan ~i <br /> Aad bl-f- 9ill v1savel It; k" S-e-f-- <br /> -X- <br /> - UST OwsnerK)pna[or ds n:sportsibfe lbr errsrrcirg that 1 J aha darylrourine UST ma7ironr+g b[IJvine end maintaance of UST leak detection equipm at covered by <br /> this plan occurs,2)all conditions that indicate a potsible release arc investigated,and 3)all monitoring records we maintained properly. <br /> The followin persons)are respornible for performing the monitoring and equipment maintenance: <br /> NAME non TITLE G w 1'L•c v— 490-73 <br /> NAME 1 N 490-74 TITLE �✓ Hots <br /> 7be D1e3jImS d fpesauv xhall pojunn a momNy vwLwj inspection of the facility,provide a report to owner/operator,and inform the owner/opento of sty <br /> conditions that rood follow-up action. <br /> 1 <br /> CERTIFICATION:I anti that the information Inuivided herein is true and accun ite to the best of my knowledge. <br /> APPLICANT SIGNATURE <br /> �� r ato76 DATE. <br /> IN <br /> el APPLICANT TITLE: wP <br /> APPLICANT NAME(print): N <br /> a /7 t �9 ✓ <br /> UPCF UST4[)(12/2007)314 <br />