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e UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VL UMER DISPENSER CONTAINMENT NDC)MONITORING 0-90-540- 1. UDC MONITORING IS PERFORMED USING T=FOLLOWING METHOD 490-54b ❑ I,CONTINUOUS ELECTRONIC MONITORING 1,2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE ❑4.NO DISPENSERS ❑99.OTHERS 490 5s MODEL#: 490-56. PANEL MANUFACTURER: 0-90-57 0-90-55 LEAK SENSOR MANUFACf URER MODEL#(S): a.YES �b.NO 490.59 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS D 490-M. UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN [3a.YES Bib,NO _ 490,61 FAILURE!DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES Cb.NO 12 UDC MONITORING STOPS THE FLOW OF PRODUCT AT TILE DISPENSER. s YES ❑b.NO 4"-62 a9od3 2.UDC CONSTRUCTION IS SINGLE-WALLED ❑2.DOUBLE-WALLED 49044e IF DOUBLE WALLED: UDC INTERSTrflAL SPACE IS MONITORED BY: C1 i.LIQUID 1712.PRESSURE 0 3.VACUUM 490fi4b A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES 0 b.NO W.PERIODIC SYSTEM TESTING 1, ELD TESTING:THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHASM 0-90 cs. MUST BE PERFARMED,PERIODIC ELD AS REQUIRED. 23 CCR 2644.1 D EVERY 36 MONTHS IS PERFOItME SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. ago 66 SPILL BUCKETS ARE TESTED ANNUALLY. a9rwr VIII.RECORDIMPING e following monitoring! ntettance nocords are kept fort16 thcility lann logs 49oas. UVisual inspection Records 4"b W Tank integrity testing results 49"k SIR testing results(and supporting documentation records). 490-find ❑ Tank gauging results(and supporting documentation records). 49o.sse ATG Testing results(and supporting documentation records).4w6w (3 Corrosion Protection 60-day logs 49o.sas Equipment maintenance and calibration records. 49"M IX.TRAINING ❑Persoaeel with UST monitoring mponsibgkies ate familiar with all of the foUaMng dommmmts televant to their job duties. 49o.s9. RE RENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)woo OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)49ofi9c CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 4sac9d CALIFORNIA UNDERGROUND STORAGE TANK LAW 004% STATE WATER RESOURCES CONTROL BOARD(SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"49o-w 0 SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"4904ft ❑ OTHER(Specify):m69h,MrA This facility has a"Designated UST Operator"who has passed the Califomin UST System Operator Exam administered by the Intonational Code Council(ICC)_ "Designated UST Opetatru"will train facility employees in the proper operation and maintenance of the UST systems annually,and within 30 days of hire.This framing will include,but is not limited to,the following: A Operation of the UST systems in a maturer•consistent with the facility's best managdnent practices D 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 D Names of contact person(s)for emergencies aid monitoring alarms.490.7o X. COMMS MADDMONAL INFORMATION Provide additional comments here or' lcate how many s with information 4m specific taring procedures are attic to this plan.490-71 oui�F!l N v0- 1' « ��a 14k ib,o 5u�a! d elo M.PERSONNEL RESPONSIBILITITS The UST Owner0perator 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 rolesse are investigated,and 3)all monitoring records are maintained property. The fol ng petson(s)are a for twforming the monitoring and equipment NAME 4m-72 TrrLE )j ep- 490.73 NAME 490.74 TITLE 490.75 The Designated Operator sball perform a monthly visual inspection of the facility,provide a report to the owneloperstor,and inform the owrialoperatOr of any conditions that need follow-up axiom. XM OMMWOPERATOR SIGNATURE CER ON:I certi that the' provided herein is true and aomuate to d o best of tn knowled e. APDL NATURE 4W'7G DATE: 490.77 _]!: am A CANT NAME(print). 4W73 qpPLTM: 490-79 c9m UPCF UST D(12/2W7)314 N IIJJ (LLL rrrr------•••"', 3 ale