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UNIFIED PROGRAM CONSOLIDATED FORb; <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN (Page 2 of 2) <br /> VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING <br /> L UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-540- <br /> ❑ 1.CONTINUOUS ELECTRONIC MONITORING 9-2.FLOAT AND CHAIN ASSEMBLY _E13.ELECTRONIC STAND-ALONE 490-546 <br /> ❑4.NO DISPENSERS ❑99.OTHER(Specify): <br /> PANEL MANUFACTURER r),lbalrev 490.55 MODEL#: l_I t C.� 490.56, <br /> LEAK SENSOR MANUFACTURER'' ea7Le C 0-;h^ - U 490.57 MODEL#(S): 6 C) 490-58 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS rl a_YES [9-b-NO 490-59 <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN a.YES 0-b-NO 490'60. <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES 0.b NO 490-61 <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER C4� YES ❑b.NO 49x62 <br /> 2.UDC CONSTRUCTION IS St.SINGLE-WALLED ❑2.DOUBLE-WALLED 490-63 <br /> IF DOUBLE WALLED: 490-.4. <br /> UDC INTERSTITIAL SPACE IS MONITORED BY: 1.LIQUID 0 2.PRESSURE 3.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a_YES ❑b.NO 490-646 <br /> VII.PERIODIC SYSTEM TESTING <br /> 1, ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65. <br /> LEAK DEE ELD MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED. 23 CCR 2644.] <br /> 0-2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490-66 <br /> SPILL BUCKETS ARE TESTED ANNUALLY. 490-67 <br /> VIII.RECORDKEEPING <br /> The following monitoring/maintenance records are kept for this facility: <br /> ❑Alarm logs 490-68a ❑Visual Inspection Records 490.686 ❑Tank integrity testing results 490-68c <br /> ❑SIR testing results(and supporting documentation records). 490-ad ❑ Tank gauging results(and supporting documentation records). 49"m <br /> ❑ATG Testing results(and supporting documentation records).490-68r ❑ Corrosion Protection 60-day logs 49"9 <br /> ❑Equipment maintenance and calibration records. 490.6gh <br /> IX.TRAINING <br /> ❑Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 490-69. <br /> REFERENCE DOCUMENTS MAINCAINED AT FACILITY(Check all that apply) <br /> [3-THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490-696 <br /> 010PERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490.69c <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 4901-69e <br /> ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND <br /> STATISTICAL INVENTORY RECONCILIATION"490-691' <br /> ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490-69g <br /> ❑ OTHER(Specify):PA69h M69i <br /> This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council(ICC). <br /> 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 <br /> training will include,but is not limited to,the following: <br /> • Operation of the UST systems in a manner consistent with the facility's best management practices <br /> ➢ The facility employee's role with regard to the monitoring equipment as specified in this UST Monitoring Plan <br /> • The facility employee's role with regard to spills and overfills as specified in the UST Response Plan <br /> ➢ Names of contact persA(s)for emergencies and monitoring alarms.490-70 <br /> X. COMMENTS/ADDITIONAL INFORMATION <br /> Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are <br /> atattached to this plan.49041 <br /> XI.PERSONNEL ItESPONSIBELITIES <br /> The UST Owner/Operator is responsible for ensuring that:])the daily/routine UST monitoring activities and maintgnance of UST leak detection equipment covered by <br /> this plan occurs,2)all conditions that indicate a possible release are investigated,and 3)all monitoring records are maintained properly. <br /> The following person(s)are responsible for performing the monitoring and equipment maintenance: <br /> NAME 49o-72 TITLE 490-73 <br /> NAME 490.74 TITLE 490-75 <br /> 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 <br /> conditions that need follow-up action. <br /> XII.OWNER/OPERATOR SIGNATURE <br /> CERTIFICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. <br /> APPLICANT SIGNATI rR F. . 490-76 DATE: 490.77 <br /> 0 Cfl L WYE 1 6-2—b 2- /S <br /> REPRFSENrtNG 1 Ta mmed0umlor O 2 Fedlity Owne/Ooerator O 3.Author nd R—mmtWive or Owner <br /> APPLIC NAME 490.78 APPLICANT Tyl�L_E_ 490-79 <br /> UPCF UST-D(12/2007)3/4 17 ,S /r <br /> 6_'�ri—v V hy <br />