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JNIPIED PROGRAJM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) Vi. UNDER DISPENSER CONTAINMENT(UDC)MONITORING 1, UDC MONITORING 1S PERFORMED USING THE FOLLOWING METHOD 490,54. 1$ 1.CONTINUOUS ELECTRONIC MONITORING [12-FLOAT AND CHAIN ASSEMBLY r] 3.ELECTRONIC STAND-ALONE 490.74b ❑ 4.NO DISPENSERS 099.OTHER(Specify): -57 :MODEL i� PANEL MANUFACTURER: 490O 490-56. -------- ------ LEAK SENSOR MANUFACTURER: 470-57 MODEL#(S): — 490.58 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLF AND VISUAL ALARMS �$a.YtS ❑b-NO 490-59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP 5HUTDOWNa.YES ❑b.NO 490-60. FAILURE 1 DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. a YES ❑b.NO 490-61 UDC.MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER a.YES b.NO 4042 2.UDC CONSTRUCTION IS -63❑2.DOUBLE-WALLED 490-63 If DOUBLE WALLED: d9063'a' VUDC INTERSTITIAL SPACE IS MONITORED BY: ❑1_L1 UUID 2,PRESSUREQ 3.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS Q a.YES ❑b.NO ` 497546 VII.PERIODIC SYSTEM TESTING 1, ELD TESTfNG: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARDTHA ENHANCED 49057. f, �D$TECTION fEL MUST BE PERFORMED, PERIODIC ELD iS PERFORMED EVERY 36 MONTHS AS REQUIRED. 23 CCR§2 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 M__ONTHS. 490-66 3.SPILL BUCKETS ARE TESTED ANNUALLY. 490 67 t VIII.RECORDKEEPING The following monitoring/maintenance records are kept for this facility: 'EAlarm logs 49o-ra. ❑Visual inspection Records 490-68b q Tank integrity testing results 490-fisc SiR testing results(and supporting documentation records). 4%-68d ❑ Tank gauging results(and supporting documentation records). 49 8o ❑ATG Testing results(and supporting documentation records),490-68f ❑ Corrosion Protection 60-day logs 490-6S8 Equipment maintenance and calibration records. 490-68h 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)497-69b OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490-690 CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49o-69d ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-69e ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS M NUAL AND STATISTICAL INVENTORY RECONCILIATION"4W69f ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"49"98 ❑ OTHER(Specify):M69h,1,169, This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the internatiott 1 Code Council(IJkh,)s The"Designated UST Operator"will train facility employees in the proper operation and maintenance of the UST systems annual Iv,and with 30 days of hire, 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 P The facility employee's role with regard to spills and overfills as specified in the UST Response Plan Names of contact persm(s)for emergencies and monitoring alarms.490.70 X. COMMENTS/ADDITIONAL INFORMATION Provide additional comments here or indicate how many pages with additional information on specific monitoring proced4res arc 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 maintenancelof UST leak detection equipme;covered b_ythis plan occurs,2)all conditions that indicate a possible release are investigated,and 3)all monitoring records are maintain ed properly.The following p on(s)are risible for performing the monitoring Bund equipment maintenance NAME /a G 490-7a TITLE W E -vsNAME 490-74 TITLE -75The Designated Operator shall perform a monthly Yisual inspection of the facility, provide a report to the owner/operator,and inform the wner/oparty conditions that need follow-up action. XII.OWNER/OPERATOR SIGNATURE r CERTIFICATION:I ce^that the infotmatio rovided herein is true and accurate to the best of my knoNviedge- APPLICANT SIGNATU 490-76 DATE: 490-77 Q act .F ility r/ rai r APPLICANT NAME(print): 490-78 APPLICANT TITLE: 4W79 UPCF UST-D(12/2007)3/4