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UNIFIED PROGRAM CONSOLIDATED FORAW UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490.54 P. I.CONTINUOUS ELECTRONIC MONITORING ❑2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 49 50 ❑4.NO DISPENSERS 1199.OTHER 5 i : PANEL MANUFACTURER: 490.53 1 MODEL#: ---( C .. 4456. LEAK SENSOR MANUFACTURER YQ 4osr MODEL#(S): Z o o a9o-sa DETECTION OFA LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ® a.YES �❑b.NO 4459 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN Q a YES ❑b.NO 490 0' FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑b.NO 490.61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER ❑ a.YES ❑b.NO 49462 2.,UDC CONSTRUCTION IS FBd.SINGLE-WALLED 112.DOUBLE-WALLED 490.64 IF DOUBLE WALLED: 49ofi/a UDC INTERSTITIAL SPACE IS MONITORED BY: f7l 1.LIQUID 0 2.PRESSURE 0 3.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO a9064b VII.PERIODIC SYSTEM TESTING 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 4o6t D MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED. 23 CCR 2644.1 rSECONDARY CONTAININENT COMPONENTS ARE TESTED EVERY 36 MONTHS, 490.66 2. 3.SPILL BUCKETS ARE TESTED ANNUALLY. 4s067 VIII.RECORDKEEPING The following monitoring/maintenance records are kept for this facility: .Alarm Ings 49 ga 13 don Inspection Records 49 b ❑Tank integrity testing results 49 k SIR testing results(and supporting documentation records). 490.6ad ❑ Tank gauging results(and supporting documentation records). 49 e (:ATG Testing results(and supporting documentation records).490a;ar ❑ Corrosion Protection 60-day logs 49 as Equipment maintenance and calibration records. 49 sb IX.TRAINING OPersomel with UST monitoring responsibilities are familiar with all of the following documents relevant m theirjob duties. 490.44 REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490a9b OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490b CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49 k jj CALIFORNIA UNDERGROUND STORAGE TANK LAW 40594 STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"40.4r ❑ S WRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"40.695 ❑ OTHER(Specify):M69k mex jjQ This facility has a"Designated UST Operator'who has passed the California UST System Operator Exam 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: 9 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 Y The facility employee's role with regard to spills and overfills as specified in the UST Response Plan 9 Names of contact person(s)for emergencies and monitoring alarms.4 x X- COMMENTSIADDMONAL 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 this..pin occurs,2)all conditions that indicate a possible release are investigated,and 3)all monitoring records are maintained properly. The followingperson(s)are responsible for performing the monitoring and equipment maintenanar NAME Q." E — S' r7 49o-7z TITLE 490.n NAME 490.74 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.OWNER/OPERATOR SIGNATURE CERTIFICATION: I certify that the information provided herein is true and accurate to the best ofmy knowledge, APPLICANT SIGNATURE 4o-76 DATE: 49049 APPLICANT NAME(print): 478 APPLICANT TITLE: 4 '79 N oC - T S 1��J/fl4 ✓�t/6 d UPCF UST-D(1212007)3/4