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UNIFIED PROGRAM CONSOLIDATED FORMW UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VI.UNDER DISPENSER CONT NT MONITORING 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-54a ❑ 1.CONTINUOUS ELECTRONIC MONITORING 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 4904473 ❑4.NO DISPENSERS ❑99.OTHER(Specify): 01 -56. PANEL MANUFACTURER: 49499 MODEL#: 490 LEAK SENSOR MANUFACTURER: 490-57 1 MODEL#(S): 490.59 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑ a.YES El b.NO 490-59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ❑ a.YES E2 b.NO 490.60. FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES .NO 490-61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER Wa.YES ❑b.NO 49x62 2.UDC CONSTRUCTION IS 111.SINGLE-WALLED ❑2.DOUBLE-WALLED 490.63 IF DOUBLE WALLED: 49064a UDC INTERSTITIAL SPACE IS MONITORED BY: 1.LIQUID 0 2.PRESSURE 3.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO a90-6ab VII.PERIODIC SYSTEM TESTING I. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED -- EMM E MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED. 23 CCR 2644.1 SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490.66 SPILL BUCKETS ARE TESTED ANNUALLY. 49"7 VIII.RECORD PING e following monitoring/ma'ntenance records are kept for this facility: larm logs 490-69e LI&Visual Inspection Records ago-M Tank integrity testing results a SIR testing results(and supporting documentation records). 0-w 6sa Tank gauging results(and supporting documentation records). 4go-6se ATG Testing results(and supporting documentation records).490.6sf Corrosion Protection 60-day logs 490.68s Equipment maintenance and calibration records. 490-6a DL TRAPONG ❑Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 49"% RE RENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)49U69b OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)4go-6% CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49"9d CALIFORNIA UNDERGROUND STORAGE TANK LAW 4 STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"4sa69f ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"a90-69s ❑ OTHER(Specify):m69k M69i This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council(ICC). e"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 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 • The facility employee's role with regard to spills and overfills as specified in the UST Response Plan ➢ Names of contact person(s)for emergencies and monitoring alarms.490-7o X. CO NTS(ADDITIONAL INFORMATION Provide additional comments here or'tMoicate how many pages with addi' nal information on specific tutoring procedures are attar ed to this plan.a9D-n AN � fl V bra T u 1 ® e/� l XI.PERSONNEL RESPONSIBIU71ES 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 plan occurs,2)all conditions that indicate a possible release are investigated,and 3)all monitoring records are maintained properly. The fol lig person(s)are respoib a for orming the monitoring and equipment NAME agor2 TITLE 490-73 NAME 4w-74 TITLE MA.42490-75 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 SIGMA CER TION:I certify that the Lnftnation provided herein,is true mid accurate to the best of my knowled e. APFLI ANT IGNATURE I 49t1-76 DATE: 49oa7 91 121, AF CANT NAME(print): 490-79 APPL NT E: 490-79 UPCF UST-D(12/2W7)31/4