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2006 02:12 #0873 P.002 /002 { UNIFIED,PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE"TANK MONITORING PLAN (Page 2 of 2) V1.UNDER DISPENSER CONT UNMENT(UDC)MONITORING I. UDC MONITORVIG IS PERFORMED USING THF..NOLLOVdING METHOD Baro Sea ❑ 1.CONTINUOUS ELECTRONIC MONITORING [12.FLOAT AND CHAIN ASSEMBLYa9o•sab ❑ 3.ELECTRONIC STAND-ALONE ®9.NO DIS PBN$ERS 99.OTHER(Specify): _ PANEL MANUFACTURER490-, .�-- LEAK SENSOR MANUFACTURER: �� g �\ ��•p a9o-s7 p ry I {STB V! NIODi'+L lits): •......—._...._-- 990,�a DETSCI'ION OF A LEAK INTO THE UDC TRIGO>RS AUDIBLF ANU VISUAL ALARMS �.YES ©b.NO 69o.s� UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP, (2"a YFS ❑b.NO a0a� FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN- ,®'a.YES n b,NO 490'61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ❑ a YES ❑b NO app 6� 2,UDC CONSTRUCTION IS SINOL&WALLS[) 112.DOUBLE-WALLED aopd5 IFDOUaLP,WALLED: . UDC INTERSTITIAL SPACE IS MOtgTORSD 13Y: ❑I,LI t1ID 2.PR£SSURG El 3.VACUUM ___ ALCAKWITHINTHESECONDARYCONTAINMENTOFTH OC�TRIGGERSAUDIBLEANL)VISUALALARMS QaYES ❑b.NO a9U4b F II.PEMODIC SYSTEM TES'T'ING ❑ 1,D+i.D TIMING: THIS RACIEf'fY HAS BEEN NOTIMED BY THi;STATE WAJU RESOURCES CO'NTROi, ARD THAT ENHANC.£D �4>. RA Dh'FECTf N F K_MUST 8r•PERFORM1-"2 PERIODIC ELI IS P$RFORMEI EVERY 36 MONTHS AS_REQUIRE�D•(23 CCR 2.644. IL [12.SECONDARY CONTAINMENT-COMPON`9N•FS ARE TESTED EVERY 36 MONTHS. 490-66 ❑3.SPIT L Bi1CAC$Y'S ARE TESTED ANNUALLY. _..__. ._.. _--.-- YIII.RECOP.M.E EPING following monitoring/r iaintenancc reords are krpt for this facility The logs 696,C,ac B"Visual Inspection Records 490 SM 'fank integrity testing results a90.Gse ❑S[R testing results(and supporting docrmtenration rE�ords}. a��sd Tank gauging rowits(and supporting documentation records). e9049. LJ ATG I-ewng remits(and supporting documentation records).4"r ❑ Corrosion Protection 60ddy logs 49o4s, uipment maintarancc and calibration t orris a9odsh 491 kS L R IX.TRAINING L J - Personnel Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 4"6% RENCE DOCUMENTS MAINTAINED AT PACILIT'k(Check all that apply) WIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)49M9b OPERATING MANUALS FOR ELECTRONIC MONI'T'ORING EQUIPMENT(Rcquired)4m9a ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-uaa ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW asw,-% ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS MANUAL AND STATISTICAL INVENTORY RECONCILIATION"4%.wF ❑ SWRC13 PUBLICATION:"UNDERSTANDING AUTOMATIC"TANK GAUGING SYSTEMS"a90-ft ❑ OTHER(Specify)!1,46%,6a69i Phis t$r lity has a"Designated UST Upnrator'who has passed the California UST Sy OperatOr Exam administered by the Internatiorurl Code Council(ICC), The"Designated UST Operator"will train facility cmploy=s in the proper opers4on and maintenance of the UST systems annually.and within 30 days of hue.This training will include,but is not limited to,the following: > Operation of the UST systanls in a manner consistent with tho facility's best management practice > The facility employee's role with regard to the monitoring equipment as specified in this UST Monitoring Phan j > The facility employde's role with regard to spills and overfills as specifod in the UST Response Phan J > Names of contact person(s)for emergencies and monitoring alarms.aux, X, COMMIEN'ISIADDITIONAL INFORMATION If Provide additional comments here or indieLatc how many pages with additsOrlai information(o�q specific monitoring procedures ere zattached to this plan.41.V.71 Vv XI.PERSONNEL RESPONSIBILITIES The UST OwnerOperator' ible for ensuring that 1)the daihy/rnutine UST monitoring activities and maintenance of UST leak detection equipment covered by i this plan 2)all c ti s th indicate a possible release arc Investigated,and 3)all monitoring records are maintained properly. { Tlxs foliowi s} Po for performing rtrc monitoring and equipment mains e' NAME p coca TITLE NAMh �•-- seas I 4M74 'I'1'I'LI3 4W76 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. XI 1.OWNEIUOPERA'1'OR SIGNATURE CERTIFICATION I qlruflthar t informatio rrv_ided herein is true and accurate to the best of my knowlctlge. t APPLICANTS[ TU 490.76 DATE:1// 4 777 RF.PRF z Fant' .i ^�^ �• I { ,s! rrf��//—/ APPLICANT NAME(print): em's APPLICANT TITLE /! V / a�� VPCF UST-0(22/2007)314