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• UNIFIED PROGRAM CONSOLIDATED FORMW UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING • I. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 49 543 MI ❑ El CONTINUOUS ELECTRONIC MONITORING 2.FLOAT AND CHAIN ASSEMBLY 3.ELECTRONIC STAND-ALONE 49a-54b ❑4.NO DISPENSERS 099.0 THERS ci ): PANEL MANUFACTURER: " ( 4so-ss MODEL#: V 49 56. LEAK SENSOR MANUFACTURER: 490.51 MODEL#(S): 490.53 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ga.YES ❑b.NO 490-59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN �a YES [3b.NO 49a6o. FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. a.YES ❑b.NO 49°'61 UDC MONITORING STOPS�THE FLOW OF PRODUCT AT THE DISPENSER. ❑ a.YES ❑b.NO 49062 y 2.UDC CONSTRUCTION IS L 7 SINGLE-WALLED 112.DOUBLE-WALLED 49 3 IF DOUBLE WALLED: 49064. UDC INTERSTITIAL SPACE IS MONITORED BY: 0 1.LIQUID 2.PRESSURE 0 3.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO 49 b VII.PERIODIC SYSTEM TESTING 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 49 5. LEAK DETECTION LELD)MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED. 23 CCR 2644.1 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 49056 _Jal.SPILL BUCKETS ARE TESTED ANNUALLY. 490o-67 VIII.RECORDKEEPING Th following monitoring/ma' nonce records are kept for this facility: Alarm logs 490-683 Visual Inspection Records 490.686 ❑Tank integrity testing results 39o*& ❑SIR testing results(and supporting documentation records). 49o-63d ❑ Tank gauging results(and supporting documentation records). 49053. ❑ATG Testing results(and supporting documentation records).49o.63f ❑ Comasion Protection 60-day logs 490.683 '09Equipment maintenance and calibration records. 490.683 IX.TRAINING -Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 490694 REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)493696 • OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490594 CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49 w ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 49069° ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"49o59r ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490.693 ❑ OTHER(Specify):M69kms. This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council(ICC). e"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 • The facility employee's role with regard to spills and overfills as specified in the UST Response Plan • Names of contact person(s)for emergencies and monitoring alarms.4soao 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 M.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 this plan occurs,2)all conditions that indicate a possible release are investigated,and 3)all monitoring records are maintained properly. The foi1Qgpn rson(s)a res nsi a for performing the monitoring and equipment main n0- NAME C 4s 72 TITLE 49 73 NAME 490-14 TITLE 490-75 The Designated 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. XII.OWNERIOPERATOR SIGNATURE CERTIFICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. APP NATURE 450.16 DATE: /�l/� 490-n s.Aim d, a `// V� l APPLICANT NAME(print): 10.18 APPLICANT TITLE: r 49039 UPCF UST-D(12/2007)3/4 Vw