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NIFIED PROGRAM CONSOLIDATED FOR <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN (Page 2 of 2) <br /> VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING <br /> 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-54a490-54b <br /> 1.CONTINUOUS ELECTRONIC MONITORING El 2.FLOAT AND CHAIN ASSEMBLY El 3.ELECTRONIC STAND-ALONE <br /> ❑ 4.NO DISPENSERS [199.OTHER(Specify): -------—-–---------------------–---------------- <br /> PANEL MANUFACTURER: MODEL#: <br /> -------—-----–––––---------------------------–---–------ 490-56. <br /> ——-----—--------------–--------------------------------- <br /> LEAK SENSOR MANUFACTURER: 496W -MODEL#(S):---------------—--------------------------- 490-58 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS M a.YES El b.NO 490-59 <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN El a.YES El b.NO 490-60. <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. 0 a.YES El b.NO 490-61 <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. 0 a.YES D b.NO 490-62 <br /> 2.UDC CONSTRUCTION IS :9 1.SINGLE-WALLED M 2.DOUBLE-WALLED 490-63 <br /> IF DOUBLE WALLED: 490-64a <br /> UDC INTERSTITIAL SPACE IS MONITORED BY: [11.LIQUID E]2.PRESSURE El 3.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS D a.YES El b.No 490-64b <br /> VII.PERIODIC SYSTEM TESTING <br /> 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65. <br /> EAK DETECTION !��tLl]�ED.(23g §2644.1) <br /> —–-------LETECTI <br /> ---–----–------------- )MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AQ <br /> 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490-66 <br /> ——----—----------------——--- ---------—- ------------------------------------------------ <br /> LL BUCKETS ARE TESTED ANNUALLY. 490-67 <br /> VIII.kECORDKEEPING <br /> The following monitoring/maintenance records are kept for this facility: <br /> 09 Alarm logs 490-68a 51 Visual Inspection Records 490-68b '®'Tank integrity testing results 490-68c <br /> E:1 SIR testing results(and supporting documentation records). 490-68d F1 Tank gauging results(and supporting documentation records). 490-68e <br /> El ATG Testing results(and supporting documentation records).490-68f El Corrosion Protection 60-day logs 490-68g <br /> ❑Equipment maintenance and calibration records. 490-68h <br /> IX.TRAINING <br /> El Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 490-69a <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITYo(Check all that apply) <br /> THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490-69b <br /> OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490-69c <br /> CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d <br /> CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-69e <br /> ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND <br /> STATISTICAL INVENTORY RECONCILIATION"490-69f <br /> ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490-69g <br /> El OTHER(Specify):M69h,M69i <br /> El This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council(ICC). <br /> The"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 <br /> training will include,but is not limited to,the following: <br /> > Operation of the UST systems in a manner consistent with the facility's best management practices <br /> > The facility employee's role with regard to the monitoring equipment as specified in this UST Monitoring Plan <br /> > The facility employee's role with regard to spills and overfills as specified in the UST Response Plan <br /> > Names of contact person(s)for emergencies and monitoring alarms.490-70 <br /> X. COMMENTS/ADDITIONAL INFORMATION <br /> Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan.490-71 <br /> 'V <br /> m�A $4 Ot 9E/- ( Fjoprer) <br /> XI.PERSONNEL RESPONSIBILITIES <br /> 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 <br /> this plan occurs,2)all conditions that indicate a possible release are investigated,and 3)all monitoring records are maintained properly. <br /> The following person(s)are responsible for performing the monitoring and equipment maintenance: <br /> NAME 490-72 TITLE 490-73 <br /> NAME 490-74 TITLE 490-75 <br /> 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 <br /> conditions that need follow-up action. <br /> XII.OWNER/OPERATOR SIGNATURE <br /> CERTPICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. <br /> APPLI T SI NAT 490-76 DATE: 490-77 <br /> REPRE I I ank Owner/ ?lot M 2.Facility 0wrier/Overator Q 3.Authorized Representative of Owner 23 Q ur <br /> APPLICANT NAME(print):Go , 490-78 APPLICANT TITLE: 490-79 is C- - k�a <br /> UPCF UST-D(12/2007)3/4 <br />