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UE042 UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-54b 490-54b ❑ 1.CONTINUOUS ELECTRONIC MONITORING ❑ 2.FLOAT AND CHAiN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE ®4.NO DISPENSERS ❑99.OTHER(Specify): _ PANEL MANUFACTURER: _a90-s5 MODEL# 490-56. LEAK SENSOR MANUFACTURER: _49°-s7 MODEL#(S): W� 490-58 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑ ..YES ❑b.NO 490-59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ❑ a.YES ❑b.NO 490-60. FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑b.NO 490-61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ❑ a.YES ❑b.NO 490-62 490-63 ❑2.DOUBLE-WALLED 2.UDC CONSTRUCTION IS 1:11.SiNGLE-WALLED IF DOUBLE WALLED: 490-64a UDC INTERSTITIAL SPACE iS MONITORED BY: [11.Li UiD ❑2.PRESSURE [13.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND ViSUAL ALARMS ❑a.YES ❑b.NO 490-64b VII.PERIODIC SYSTEM TESTING 1. ELD TESTING: THiS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 49x65. LEAK DETECTION ELDj MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED.(23 CCR§2644.1) ®2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490-66 3.SPILL BUCKETS ARE TESTED ANNUALLY. _ 490-67 VIII.RECORDKEEPING The following monitcring/maintenance records are kept for this facility: ®Alarm logs 49o.68a ®Visual inspection Records 490-6m, ❑Tank integrity testing results 490-65- ❑SiR testing results(and supporting documentation records). 490-68d ❑ Tank gauging results(and supporting documentation records). 490-68e ❑ATG Testing results(and supporting documentation records).490-68f ❑ Corrosion Protection 60-day logs 490-685 ®Equipment maintenance and calibration records. 49048h IX.TRAINING ®Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their jobs duties. 49o-m9 REFERENCE DOCUMENTS MAINTAINED AT FACILITY'❑(Check all that apply) ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490-69b ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490-69,- ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490.694 ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 490469e ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"49o-6w ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490-69g ❑ OTHER(Specify):moh,m69i This facility has a"Designated UST Operator"who has passed the California UST System operator Exam administered by the International Code Council(ICC). 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 training will include,but is not limited to,the following: D Operation of the UST systems m 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 persorr(s)for emergencies and monitoring alarms.490-70 X. COMMENTSIADDiTIONAL INFORMATION Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan.490-71 Fill Tube Shut-Off Valve is the Primary Overfill Protection Device on this system,set to 95%of tank capacity. Overfill Alarm is set to 90n/n of tank capacity. (L2)Fill S (1-3)Middle Sump,(L5)Supply Transition Box,(1-6)Vent Transition Box&(1-7)Pump Pan Sensors(5)-794380208 XL PERSONNEL RESPONSIBILITIES The UST Owrter/Operator is responsible for ensuring that: 1)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment covered by this plait occurs,2)all conditions that indicate a possible release are investigated,and 3)all monitoring records are maintained properly. The following person(,$)are responsible for performing the monitoring and equipment maintenance. NAME Tart Environmental Services 490-72 TiTLE AT&T Authorized Vendor (Contact List available upon request) 490-73 NAME AT&T Environment Health&Safety 490-74 TITLE Call Center 490-75 The Designated Operator shallperform a monthly visual inspection of the facility, provide a report to the owner/operator, and inform the owner/operator of arry conditions that need follow-up'action. XII.OWNF"PERATOR SIGNATURE CERTIFICATION:I certify that the informatio ovided herein is true and accurate to the best of my knowledge. APPLICANT SIGNATURE 490-76 DATE: 490-77 5/2/2912 PTFE N .Tank. n /- ora r :Nap e -nr tive of Owner APPLICANT NAME(print): 490-7s APPLICANT TITLE: 490-79 Steven J Hall mamgff,M&S UPCF UST-D Ray.(11212011(7)