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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAY (Page 2 of 2) VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490.541 ❑ 1.CONTINUOUS ELECTRONIC MONITORING ❑2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 490-54b 19 4 NO DISPENSERS99.OTHER(Specify): PANE/.MANUFACTURER—❑: 49455 ( MODEL#: 490-56. LEAK SENSOR MANUFACTURER: 490 57 ; MODEL#(S): 49454 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑ a.YES ❑b.NO 49459 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ❑ a.YES ❑b.NO 490'60 FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. Cl a.YES ❑b.NO 490-61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ❑ a.YES ❑b.NO 490.62 2.UDC CONSTRUCTION IS ❑I.SINGLE-WALLED ❑2.DOUBLE-WALLED 490.63 IF DOUBLE WALLED: i90 6t1 —_UDC INTERSTITIAL SPACE IS MONITORED BY:: f 1,LIQUID 02.PRESSURE ED 3.VACUUM - ----- 0.641 A LEAK W[TH[N THE SECONDARY CONTAINMENT OF THE UDC'TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.--YES--------b ❑b.--NU-------4-99°-64b VII.PERIODIC SYSTEM TESTING I. ELD TESTING:THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490.65. __LEAK DETECTION(ELD)MUST BE PERFORMED- PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS RE_QUlRF-),AL CCR X264 .111 [12.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERT'36 MONTHS 490.66 -9999-1EC — -� —-- • 3.SPILL BUCKETS ARF,TESTED ANNUALLY. 490.67 VIII.RECORDKEEPING The following mon itoring/maintenance records are kept for this facility: El Alarm logs 490-63. (D Visual Inspection Records 490.69b ❑'rank integrity testing results 494686 ❑SIR testing results(and supporting documentation records). 490-68d ❑ Tank gauging results(and supporting documentation records). 490.6se ❑ATG Testing results(and supporting documentation records).49o.68r ❑ Corrosion Protection 60-day logs 490-69a Equipment maintenance and calibration records. 49o-6ab 1X.TRAINING . Q Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 490-691 REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) El THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490591 Q OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490-696 ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-69. ❑ STATE WATER RESOURCES CONTROL BOARD(SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"490-69r ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490-698 ❑ OTHER(Specify):M69h,M69i IN This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council(ICC) I The"Dee;gnatcd 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: Y Operation of the UST systems in 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 Y The facility employee's role with regard to spills and overfills as specified in the UST Response Plan i Names of contact person(s)for emergencies and monitoring alarms.490.70 X. COMMENTS/ADDITIONAL INFORMATION Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan 490-7! The waste oil tank has an overfill liquid sensor which triggers an audible/visual alarm on the Ronan monitoring panel when the tank is 90%full. XI.PERSONNEL RESPONSIBILITIES The UST Owner/Operator is responsible for ensuring that: 1)the dailviroutine UST monitoring activities and maintenance of UST leak detection equipment covered by this plan occurs,2)all conditions that indicate a possible release arc investigated,and 3)all monitoring records are maintained properly. The following person(s)are responsible for performing the monitoring and equipment maintenance NAME Allen Faass 490.72 TITLE Tank and Pump Maintenace 490.73 NAME Allen Faass 490.74 'TITLE Testing 490-75 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. XIL OWNERIOPERATOR SIGNATURE CERTIFICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. APPLICANT SIGNATURE 490-76 DATE: 490.77 SEtiT/NG•❑1 lank Ovvnm'Ooew�r❑ Facility t),srar/0ee 0-r ❑3 AuaSarized Rearesentative of Owner APPLICANT NAME(print): 4fl0'75 APPLICANT TITLE: 4W79 Allen Faass Compliance L'PCF ISTD(12/2007)3/4 y ( " i