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03/02/2012 03:38 9252920074 GDF_SOLUTIONS FAX PAGE 05115 <br /> PIED PROGRAM CONSOLIDATED FORMW <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN (Page 2 of 2) <br /> VL"I N0=DISPENSER CONTA MONITORING <br /> 54 <br /> I. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 4M-46 <br /> 490.E <br /> M 1.CONTINUOUS ELECTRONIC MONITORING 1712.FLOAT AND CHAIN ASSEMBLY E3 3.ELECTRONIC STAND-ALONE <br /> ❑4.NO DISPENSERS D 99,OTHER(S ): <br /> PANEL MANUFACTURER: Veeder Root 5 MODEL#; TL&350It 490.56. <br /> LEAK SENSOR MANUFACTURER: Veeder Root 49"? MODEL#(S):794380.208/304 490-58 <br /> DETECTION OF A LEAK INTO IM UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ® a YES ❑b.NO 490.59 <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN a YES ❑b,NO 490-0' <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a YES ❑b.NO est <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ® &YES ❑b.NO 490-8 <br /> z vvc CONffmcnom IS ❑1,siNGL£-WALLED ® 2.DOUBLE-WALLED sector; <br /> IF DOUBLE WALLED: ■ <br /> UDC INTERS'TTfIAL SPACE IS MONITORED BY; I,(.1 UID ❑1 PRESSURE ©3.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OP TKE UAC TRIGGERS AUDIBLE AND VISUAL ALARMS ®a.YES ❑b,NO 490," <br /> VII:PERIODIC SYSTEM TESTING <br /> 1, ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY TfIE STATE WATER RESOURCES CONTROL BOARD THAT 4 45, <br /> MUST BE PERFORMED, PERIODIC ELD IS PWORMED EVERY 36 MONTHS AS RE UIRFA_M CCR 2644.1 <br /> ❑2.SECONDARY CONTAINMENT COMPONENT'S ARE TESTED EVERY 36 MONTHS. 490.0 <br /> 3,SPILL BUCKETS ARE'1I:SI'ED ANNUALLY. 4W67 <br /> VIII.RECORDI PING <br /> The following monitabg/msilftnance reeds are kept for this facility., <br /> ®Alarm logs 4*4u ❑Visual Inspection Records 490.sab ❑Tank integrity testing results 49o-6u <br /> ❑SIR testing results(and supporting documentation records). 490.6sd Il Tank gauging results(and supporting documentation records). 49US. <br /> ❑ATO Testing results(and supporting docurrnerntatiou records)_4w ar Q Condon Protection 60-day logs 49"as <br /> Equipment maintenance and calibration records, 490695 <br /> DL TRAIMM <br /> ®Personnel with UST monitoring responsibilities are f imilier with all of the following doe marts relevant to their job duties. 490,698 <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY0(Chalk all that apply) <br /> ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) <br /> OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)49a6se <br /> ❑ CALIFORNIA UNDERGROUND STORAGE'TANK REGULATIONS 49a494 <br /> ❑ CALIFORNIA,UNDERGROUND STORAGE TANK LAW 490-ft <br /> ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND <br /> STATISTICAL INVENTORY RECONCILIATION"4mor <br /> ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"4wft <br /> ❑ OTHER(Specify):mok ma <br /> This facility has a"Designated UST Operator"who has passed the California UST System Operator Eum administered by the Imenuational Code Council(ICC). <br /> The"Designated UST Operator"will train facility employees in the proper operation and maimena m of the UST systems annually,and within 30 days of hire.This <br /> training will include,but is not limited to,the following; <br /> D Operation of the UST Systems in a rnaom consistent with the f ialitys hest mmagenicat practices <br /> A The facility employee's role with regard to tate monitoring equipment as specified in this UST[Monitoring Plan <br /> D The facility employees role with regard to spills and overfills as specified in the UST Response Plan <br /> > Names of omtaet persan(s)for emergencies and monitoring alarms.4w7o <br /> X. COMMZNTS/ADDITIONAL INFORMATION <br /> Provide additional comnnanls lucre or indicate how many pages with additional' an specific monitoring procedures are Oft4 ed to this plan.49a71 <br /> Overfill Alarm is set at 9(i% <br /> XL MRSONNEL'"SPONSMUX=S <br /> The UST Owner/Operator is ropo Bible fbr during dot:I)the di ily/routine UST monitoring activities and maintenar a of UST leak detection equiputent covered by <br /> this plan occurs,2)all conditions that indicate a possible release aro investigated,and 3)all monitoring records are maintained property, <br /> The following persort(s)aro responsible for performing the monitoring and equipment maintenance: <br /> NAME Dave Hinds 4Wt2 TITLE Sales Manager 490.73 <br /> NAME Mike Abmadi 4m74TI1rLE Dealer "0.7s <br /> The Designated Openuor shall perform a monthly visual inspection of the facility, provide a report to the ownedoptraw,and inform the owncdoperator of any <br /> conditions that need follow-up action. <br /> XIL OWNER/OPERATOR SIGNATURE <br /> CERTIFiIC :I cortify that the i ation provided herein is true and accurate to the bast of my knowledge. <br /> APPLICA 490.76 DATE: a9a77 <br /> February 2,2012 <br /> APPLICANT NAME(prim): 496' APPLICANT TITLE: 49x79 <br /> Mike Ahmadi Dealer <br /> UST Response Plan(31Z0(I$)313 <br />