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U1�ip ED PAppR,41M CONSOLIDATED FORM <br /> UNDERGROUND nopAGE TANK <br /> �p MoNffoiUNG PLAN ((�w/0") ray <br /> VI.UNDEII DISPENSER CONTAINMENT1•,•.�.')MONI l ORMG a90 340 <br /> d9034b <br /> 1. UDC MONITORING M"U""am USINIG T1>iSy�{F{OLLOWING MBTHOI, <br /> ELECTRONIC MONITORlNCI A4 2,FLOAT AND CHAIN ASS6MRLY C] 3,q,) 1 RONIC STAND-ALONE <br /> ❑ 1.CONTINUOUS490-se. <br /> ❑a.NO INSFENSERs ❑99.OTHER 3 3 : 49o35 MODEL a: _—---- <br /> 4903a <br /> PANEL MANUFACTURER: 490.39 MODID N(S$ <br /> (] :.Yes �b.NO 49039 <br /> L1;AK SENSOR MANUFACTURER: a9o.6o. <br /> pETECTION OF A LEAK INTO THB UDC TRIOOERS AI DMILZ AND VISUAL ALARMS 13 a.YES b.NO <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN 49 Oil <br /> RS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES Q,�.b.NO <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRKMRS a.YES ❑b.NO 49062 <br /> UDC MONITORING STOPS TIB FLOW OF PRODUCT AT THE DISPENSER- a9abs <br /> 2,i1DC corlsrRuerloN M �I.sINfiLE-WALLED ❑2 A6)17BLE-VUAtd.ED 490 ++ <br /> IF DOUBLE WAd.LED: a9a•6ab <br /> iJDG It+TTERS'ft17AL DACE IS MONITOR.BD$Y: i. UID 2.PRESSURE 3.VACUUM <br /> A LEAK WITHIN TETE gg170NDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISiIAL AL/tRMB D a.Yias Q b.NO <br /> vII.riwRiioDlc s�sTE�TE�TI>nrc _ • <br /> 1. GILD TESTING:TEItS FACT BE PERFORMED PM)DIC BW a PWORMED EVERY 36 M0IVTELS AS �UJRED 23 GCR� ago <br /> 49064 <br /> 5 <br /> ()2.SECONDARY CONTA94MIT COMPONENTS ARiL TESTED EMERY 36 MONTHS. 49"7 <br /> 3.9PILL BUCli3E ltwmmm TESTED ANNUALLY. <br /> VIII.RECOHDIMPING <br /> The Ydlowin&maaaitoaitngJ �sBe>�fir the flicility: <br /> farm logs Oso 6a. Visaed laspecdon Reooeds a9o4ab Tank integrity testing results 404 6C <br /> rATG <br /> gresults(and supporting docatneentatian records). 49"ad Tank gangingre9ult8(turdsttppotingdoe+unantstionrecors). a9tKi8a <br /> Testing results(and suppartlttg do mOaUon faelllft 40611' Corrosion Protection 604ay logs 49"k <br /> �FquipmeM meintena»ce and 4atiibndiort mcm l&490 5N <br /> IX.TRAIIV NG . <br /> ❑Petaoml with UST monitoring responsibilities aro floogiar with all of the following documents relevant to tbair job datles. 4w4% <br /> R RENCE DOCUMENTS MAINTAINED AT FACQ.M(Check all that apply) <br /> THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Requhetq 490-mb <br /> OPERATING MANUALS FOR BLECTRONIC WNfrORiNG EQU MOM(Rcqutred)4"-&c <br /> CALiFOMM UNDERGROUND STORA(M TANK REGULATIONS 4;o�w <br /> CALi':FORNIA UNDERGROUND STORAGE TANK LAW 49mw <br /> STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDWOK FOR TANK OWNERS - MANUAL AND <br /> STATISTICAL INVENTORY RECONCILiATION"4",W <br /> 3WRC8 PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"49m69a <br /> OTHER.(Speoft mak um <br /> This 6ality has a"Deftwded UST Operator"who las passed rho Caitfomia UST System Operator Exam adRtinistered by the hMnadenO Cade Council(ICC). <br /> The"Dempated UST OpeMor"will Gain facility employes in the propel opmado n and meimtenenee of the UST symns annually,and within 30 days of hint.This <br /> training will include,but is not limited to,the f WlowltR: <br /> y Opsmilim ofta usT syatatva hi am mlcr coiteifitmit wilk ttiltcility's beg mat proven prttctiae9 <br /> The Ocility employee's role with raged lathe monitoring equipment as specified in this UST Monitoring Plan <br /> p. The facility ettlployea's rote wkh regard to spills and overfilla as specified is the UST Response Plan <br /> i Names of cousnet persons)for emarpociea and awuitotng alarms,49oao <br /> X. CONI ENTSfADDITIONAL ROORMATION <br /> Provide additional comments here or inditte bow many pages wiii aWitiotal 10MMttion a specific Marl ittg Pmoodtaes ma tmaehed to this pian.4W71 <br /> j,v j/CP- Pi�.�vr �7,a•• _ p-TG +.�ro 1/�S ury4j ` 0 "Tia <br /> 3�Li.PER80NNEL <br /> Thr:UST Owner Opetwor is tesptuaibla for atsuNttg that:l)the daily/routino UST monitoring activities and maintenance of UST leek detoction equipment covered by <br /> Ibis plan occurs,2)all conditions that itwlicaBe a possible olesse are investigated,and 3)ail mankonlog records are mAnWnod properly. <br /> The fong' person(s)a responsible flue performing die monitoring and equipment medrmnmhca: <br /> NAME: 4wn TITLE aux►7a <br /> NAME - 49x74 TITLE 1&a4gAj 490-75 <br /> The Designated Operator shall perfoen a mombly visual inspection of the thcility,provide a report to the owrar/operator,and inform the owner/operator of any <br /> ene dations that need tbnovwup action. <br /> X11.OWNMOPERATOA SIGNATOR$ <br /> C13RTZiFi : <br /> lautit that the 'ora Provided horcin is Uuc and tIt>i urift to Nie beat ofmy#pw <br /> APPLiC 1 T[JRE 49x-75 DATE: 49077 <br /> c�,, _Aj <br /> Edo 9k 1, <br /> APP CANT NAME(print): a71 APPLICANT TR'LE: ` 490.79 <br /> 1�f <br /> tMCF UST-0(1241W)3/4 <br /> 12- /0 <br />