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002188 UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VL UNDER DISPENSER CONTAINMENT(UDC)MONITORING 1. UDC MONITORING IS PERFORMED USING THF FOLLOWING METHOD 490-5a9asab 0-5 WY h ❑ 1 CONTINUOUS ELECTRONIC MONITORING 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE ❑4.NO DISPENSERS 1199 OTHER(Specify): 490 990' PANEL MANUFACTURER '55 MODEL# LEAK SENSOR MANUFACTURER 490 Sr MOREL#(S): 0-90 ss DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑ a.YES Mb.NO 490.59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ❑ a.YES1b. b.NO 490'6° FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AL70MATIC PUMP SHUTDOWN C3a.YES NO 490.61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER Q a.YESb.NO 49062 2.UDC CONSTRUCTION IS K.SINGLE-WALLED 1:12.DOUBLE-WALLED 490-63 I IF DOUBLE WALLED: 490l4a UDC INTERSTITIAL SPACE IS MONITORED BY: 0 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 49-646 VII.PERIODIC SYSTEM TESTING 1. ELD TESTING:THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 49°0-5. :AK DETECMN QM MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED. 23 CCR 2644.1 2 SECONDARY CONTAI41Y OT COMPONENTS ARE TESTED EVERY 36 MONTHS. q90-66 jq 3.SPILL BUCKETS ARE TESTED ANNUALLY 490.67 4 VIIL RECORDKEEPING The following monitoring/ termntce records aro kept for this facility: Aharm logs 490.60-0- Visual Inspection Records 490.66b 8nk integrity testing results 49"k SIR testing results(mrd supporting documentation records). 490-bsa Tank gauging results(and supporting documentation records). 490-6U TG Testing results(and supporting documentation records).490.6tf Corrosion Protaction 60-day logs 490-6% Equipment maintenance and calibration records. 49D-m IX.TRAE%NG ) T l with UST monitoring responsibilities aro familiarmvi*�n all ofthe following documents relevant to their job duties. 4w"% CE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) S UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490.69eRATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490-69e IFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 490.6% ❑ STATE WATER RESOURCES CONTROL BOARD(SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS MANUAL AND STATISTICAL INVENTORY RECONCILIATION"490.69r ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490.699 ❑ OTHER(Specify):m6w MWi This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council(ICC). i "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: • Operation of tho 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 I • The facility employee's role with regard to spills and overfills as specified in the UST Response Plan • Nantes of comact person(s)for emergencies and monitoring almma.490-7 X. CONOMTS(ADDITIONAL INFORMATION Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan.496-7n Llr M.PERSONNEL tt MNSIBRJTIES The UST Owner/Operstor is responsible for ensuring that.I)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment covered by this plan occurs,2)all conditions that indicate a possible release are investigated,and 3)all monitoring records are maintained properly The following parson(s)ate responsible for performing the monitoring and equipment maintenance: NAME 2 + " 490 n TITLE ( i 49073 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. OPERATOR SIGNATURE CERTIFICATION:I anion ided herein is and atxarrate to the best of my knowledge. APPLICANT SIGNA 49076 DATE: }} 490-0 APPLICANT NAME(Printf: 190 7s APPLICANT TITLE 490.79 cSSel V � ihawner- UPCFUST-D(1212007)N4 --7—Aj PI'ti^ dos -- ptVr'G.+s.,Q q,ti( e4p�,o4x� Gam l ��'"-T ��`��t►-�. � ��. �..-f� 9- Z -o g'