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UNIFM PROGRAM CONSOLEDATED FORM DNWRGROUND STORAGE TANK MONITORING PLAN— 2 of 2 PROW UDC)CNffORINGISPMUURbM)USING IBEFW JWMMMUM I KIL CONTINUOUS H.BCIRONIC NIOWORING Q 2 FLOATAND CHAINASSHMBLY ❑3.BLBCTRONIC STAND-ALONE 490.54& f ❑4-NO DISPENSERS ❑99.OTHSR 49034b. LEAK MONITORMANUFA1TURM -111 co 490,51 MODEL#.-rS IObO a-N 490.56. 133AXSBNSDRMANUFACPURER: Tncoi] 40Mmom# - TAP'LH DEn CIION OFA LEAK RM THE UDC TRIGM( PS AUDWEAND VISUAL AIARMs ®s.YES ❑ b.NO 49°`59. UDCLSAKALARMTRICGE8SAuimu 1crLueSHUIDOWN- 19 &YES ❑b.NO 490-60. FAQ FlDLSCONNBCiI0 N OF UDC MOMTORING SYSTEM TRIGGERS AUTDMATIC PUMP SHUIDOvim S a YES ❑ h NO °90 01- UDC 140MURING STOPS THE FLOW OF PROOUCT AT TEIE DISPENSER. ❑ s_YES h NO ago 60-. UDC CIDRSTRICHON IS: ® L SINOU SPALL ❑2 DOUBLE WALL 490-63- 1ERMIRiRW I7- 400.640- UDC RUE RSTITIAL SPACE IS MONITORED Br ❑a.LIQUID ❑h PRISSUBB ❑ G VAaAW ALEAK WMIIF THE SECONDARY CONTAINMENT OF TEE UDC TRIGGER&AUD(BLEAND VISUAL ALARMS• ❑s YBS ❑ b�No El 4_ILD T ESMia TW FACQM HAS BEEN 14MRgED BY THE STATE WATER RFSOMCPS COKO H.BOARD TEAT EMMM 49"& ! IMMIMUMMMUSTBEFERFORMM.PERIODIC ELD IS PMQRMBD EVERY 36AICH M AS JtMXW p3ccitim"il ®2-SBCOMMYCONTADBMffCOIOOEKMARhTBSrMhNWY36hi%nM. � ®3.SMI.BUCKSTSARBT84IEDANNUALJY_ uocz Tbrfr6owmg -ewAmr am rptfortldsgty: Mbi ®a ALARM=' LARMLOGS ®h VISUAL INSPBCNION RECORDS ❑Q TANX WTEGRUY TESTING RESULTS E3 d.SIR TESTING RESULTS(sad snppmt ng door rec4adr} ❑--TANK GAUGINGRESMTS(and soppwtmg doc>—tenon reooxds) L ATGT&STING RESULTS(and wMammg doammt om mxrd9) ❑g CORROSION P20IBCTM 60-DAY LOGS l�IAIIN IL lRIANGEANIDrAImPAT1QNRECORDS - i.f19 _�,.y _t�._ `fid _:�?� ii,�t .:.a 3i:.-;9.J.: __^�;3°.' s.C'}'_'-'""�'=�•��.<-'f-'_ - Pecoand with UST sookwng rcsImusibilidw are$mifar With all of the klm g dnaneats retevent to dmwjob dodw 490.6%6 REFERENCE DOCUME?M MAINTAINED ATFAWZ Y(Cheetah teatapply) ®no u NDERaRoU)ID STORAGE TANK moNnuuNG PLAIN(Regaked) 4906%. ®UPI+RAI3NGMANtEAIcFORELBCTBOWMOMTOMMEQUWME1T(Begaaed) 4W-69� I i ❑CARNIA U?U)ERGROU ND SPORA(3E TANK RBOU ATTOM 49049& [�CALHKOBtUA UNDERGROUND STORAGE TAM LAW 490-69- (�STATE WATER RESOURM CONTROL BOARD (SWRCB) Pi)BLICAWN: 'HANDBOOK FOR TANK OWNERS MANUAL. AND —W STATL4ACAL R4VBNTORY RECONCILIATION" []SWP BPUBLICATION: 1ANDIZNGAUTOMATICTANK GAUGING SYStEMr �0 OTHM(Speafyk 99'1TAs facility has a`Designated UST OpaaW who has passed the UST System Opcci"Beam arlsimistaed by the ISI Cade Coimcit . (ICC). The UST Opaow"wrl aaiu sc aity a opt in the proper opustim and m of fite UST systems anmully,and within 30 days ofhia This Laidog will iaeisda,btt is rot Wnied to,the lallowiug > OpmuionoftheUST system mamamerannbleatwiththe fsality'sbatmacogana¢Facbms > The&mhty employee's rote with regard to the nmkmm ogaipm®t as spcd ied mtiiis UST lfor¢rring PIUL > The boo empinyces robe with regard to sqis and overfi'lis as specifind m the ms's UST Respmse Plan > Hing(s)af cuabd peeim(s)for emnvmciesand monitoring-Imm - tVY�ac, a,4`�. Vii'. <<. �a•"n� -- - - = - t add t IIGC Q hOvr ap�rpPgr3 with addRroaai elf - 4m s ocific t pr00ed<RR YCatdCbOd10ffib P� 490-7T. v t+R U _ 95' oo D �S L t - �� 1q�� I1,e usT ovmiopewtoric�it e �I)the ilrtlAWwueoe UST waai�g=bvitas of Wr leaf aeon egnipao�cansed� BaL� �{p�� THE POLL0%FI IG PERSON(S)ARE RESPONSIBLE FOR PERFORMING ING THE MONITORI NO AIND BQN>>I'AAWr MAWTENANCL a n VCT TDLE .90.73. NAME -75. 80� NAM 490-7c TITLE. Tho Dwoutad LIST Opaaia dmil pato®a swuWy vimdt Wvccbw of ft fircillty,pto4ide a separt to din ownwlopeiabt and infarm the ovanodaperaeor of any thatneed fo actim C KRTMCAIM-I corft fhsst Ura htimsA'I= herein is trm asd aecuake to dw but of say r' APPLTCATNTSIGNATUBB DATE { .+Axlq W7 a Ksg2f vur 13 LTo 3.Aad.hrd or 4704& APPLECANT NAM @iii k 479-7: APMJCANTITIIE 40-0.7!. UFCaF U6T-D(12nW O-ars W W WAR isrstars Ei0/500 %V41 90 cTT III9l 6002/DO/90