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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN— (Page 2 of 3) VI.UNDER DISPENSER CONTAINMENT (UDC)MONITORING (check an that apply) UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) 490 sa4 ® 1.CONTINUOUS ELECTRONIC MONITORING El 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 490-541,. ❑ 4.NO,DISPENSERS.__._.............____.____......._.._...__0._99.OTHER(Specify) ._..._._._ 490-55. MODEL p:TLS-350 osis-ss. LEAK MONITOR MANUFACTURER:Veeder Root 490-s7. MODEL 4(s): 490-58. LEAK SENSOR MANUFACTURER:V@ed@T Root 49o-s9. DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. E a.YES ❑ b.NO UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN. E a YES ❑ b.NO 490fi0_ FAILUREIDISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. E a.YES ❑ b.NO 490-61' UDC MONITORING STOPS THE FLOW QF PRODUCT AT THE DISPENSER. E a.YES ❑ b.NO 490-62 UBLE WALL IF DOUBLE WALL: _ 490aL UDC INTERSTITIAL SPACE IS MONITORED BY: ��a.LIQUID ❑ b.PRESSURE ❑ c.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. ❑ a.YES ❑ b.NO 490-64b. VII. PERIODIC SYSTEM TESTING ❑ 1.ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65. LEAK DETECTION ELD MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED In CCR ps,,4.1] .SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 49066 49067 ® 3. SPILL BUCKETS ARE TESTED ANNUALLY. VIII. RECORD KEEPING The following monitoring/maimenance records are kept for this facility: 490-68_ ® a.ALARM LOGS E b.VISUAL INSPECTION RECORDS ❑ c.TANK INTEGRITY TESTING RESULTS ❑ d.SIR TESTING RESULTS(and supporting documentation records) ❑ e.TANK GAUGING RESULTS(and supporting documentation records) ❑ f ATG TESTING RESULTS(and supporting documentation records) ❑ g.CORROSION PROTECTION 60-DAY LOGS E h.EQUIPMENT MAINTENANCE AND CALIBRATION RECORDS IX. TRAINING E Personnel with UST monitoring responsibilities are familiar with all ofthe following documents relevant to theumb duties: 490-696 REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) E THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 490 % E OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) 490-69c ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 4906%L ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 490694 ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND 490-69[ STATISTICAL INVENTORY RECONCILIATION" ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 490-698. ❑ OTHER(Specify): 490-69h 490691 E This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council 490a0. (ICC). The "Designated UST Operator"will train facility employees in the proper operation and maintenance of the UST systems annually,and within 30 days of hire.This training will include,but is not limited to,the following: ➢ Operation of the UST systems in a manner consistent with the facility's best management practices. ➢ The facility employee's role with regard to the monitoring equipment as specified in this UST Monitoring Plan. D The facility employee's role with regard to spills and overfills w specified in the facility's UST Response Plan. ➢ Name(s)of contact person(s)for emergencies and monitoring alarms. 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. 490-71 XI. PERSONNEL RESPONSIBILITIES The UST Owner/Operator is responsible for ensuring that: 1.)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment covered -by thisplan occurs_2)all conditions that indicate a possible release are mvestigated;,and 3)all monitoring records are maintained ............ THE FOLLOWING PERSON(S)ARE RESPONSIBLE FOR PERFORMING THE MONITORING AND EQUIPMENT MAINTENANCE: NAME: SYED K. AHMED 490-72, TITLE VICE PRESIDENT 490'71' NAME: 490-74. TITTLE: 490-75 The Designated UST Operator shall perform a monthly visual inspection of the facility,provide a report to the owner/operator,and inform the owner/operator of any conditions that need follow-up action X11- OWNER/OPERATOR SIGNATURE CERTIFICATION:I cern at a infvrnaXoltP7ftjdcd herein is true and accurate to the best of my knowledge. APPLICANT SIGNATURE DATE: 490-77. REPRESEM G®1.Trak 0. 1Yor a itirismer/QperatoN3.AutrorihdRresentatiwofOwner 490-76. APPLICANT NAME(print): 490-7e. APPLICANT TITLE- d90'19 SYED K.AHMED Vice President