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UNIFIED PROGRAM CONSOLIDATED FORNPW UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VL UNDER DISPENSER CONTAINMENT(UDC)MONITORING 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 44asa. aro-sae ❑ 1.CONTINUOUS ELECTRONIC MONITORING ©-2.FLOAT AND CHAIN ASSEMBLY 0 3.ELECTRONIC STAND-ALONE ❑4.NO DISPENSERS ❑99.OTHER(Specify): PANEL MANUFACTURER: r)• [ . 4sass MODEL k: (_AC.- 4sa56. LEAK SENSOR MANUFACTURER' ea.-LL- �t'di D 490.]) 1 MODEL O(S): t3 Gy- ~9 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS rT a.YES [C}b:NO 490.59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ,.,, a YES [c]..b..NO 490'60. FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES Pb.NO 490.61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER ❑a YES ❑b.NO 490.62 2.UDC CONSTRUCTION IS St.SINGLE-WALLED ❑2.DOUBLE•WALLED 490.61 IF DOUBLE WALLED: 490'b40 UDC INTERSTITIAL SPACE IS MONITORED BY: 1.LIQUID rl 2.PRESSURE 3.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO 49a64e VII.PERIODIC SYSTEM TESTING 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 4�- L MUST BE PERFORMED. PERIODIC EIA IS PERFORMED EVERY 36 MONTHS AS REQUIRED. CCR 2644.1 [12.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 49066 .SPILL BUCKETS ARE TESTED ANNUALLY. 4�7 VIII.RECORDKEEPING The following monitoring/mainterance records are kept for this facility: ❑Alarm logs 490.6as ❑Visual Inspection Records 49 46 ❑Tank ime"testing results 49o-69a ❑SIR testing results(and supporting documentation records). 490.616 ❑ Tank gauging results(and supporting documentation records). 4906ae ❑ATG Testing results(arid supporting documentation records).4sassr ❑ Corrosion Protection 60-day logs 4s 89 ❑Equipment maintenance and calibration records. 49o.sm IIT.TRAINING ❑Personnel with UST monitoring responsibilities are familiar withal]of the following documents relevant to thebjob duties. 49n69a REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) []'THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)49069e G-OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490.69c ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49a6w ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 490.699 ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"490.691 ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"4%69a ❑ OTHER(Specify):M6W Msec This facility,has a"Designated UST Operator"who has passed the California UST System Operator Ermm administered by the International Code Council(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 consiatent with the facility's belt management practices • The facility employee's role with regard to the monitoring equipment m 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 pc n(s)for emergencies and monitoring alarms.490.90 X. COMMENTSIADDITIONAL INFORMATION Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan.490.91 V ' XI.PERSONNEL liESPONSUNUTM 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 im nigmuA and 3)all monitoring records are maintained properly. The following persim(s)are responsible for performing the monitoring and equipment mainenance NAME 49x92 TITLE 490.93 NAME 490.74 TITLE 490.95 The Designated Operator shall perform a monthly visual inspection of the facility, provide a report to the owner/operator,and inform the ownedopenator of any conditions Mat need follow-up action. XII.OWNEWOPERATOR SIGNATURE CERTIFICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. APPLICANT SIGNATURE(n 490.96 DATE: 490'» APPLICANT NAME(print): 490.n APPLICANT TITLE: 490.19 `i C =� t Inv) L • e M c,^I�. e�-- UPCF UST-D(12/2007)3/4 t �}