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FEB-26-2010 10:54A FROM: 683433 P.3 <br /> UNIFIED PROGRAM CONSOLIDATED' FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN (Page 2 of 2) <br /> V1. UNDER DISPENSER CONTAINMENT"Q MONITORING <br /> 1, UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 49o-540 <br /> ❑ LCONTINUOUS ELECTRONIC MONITORING A,.FLOAT AND CHAIN ASSEMBLY [3 3.ELECTRONIC STAND-ALONE 4W54b <br /> DISPENSERS [19%OTHEg_(Spec&L <br /> __ _ _ ._PANEL MANUFACTURER: ­ ......... <br /> 4901jDEL#: <br /> 490-S& <br /> LEAK It MANUFACTURER: 490-57 <br /> MODEL#(S).- 'J490-58 <br /> ck-A- <br /> DETEC71ON OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS a.YES 19b.NO 490.19 <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN TILa.YES 0 b.NO 400-60. <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. 0 a.YES NO 49041 <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER, Kit.YES 0 b,NO 49042 <br /> 2.UDC CONSTRUCTION IS %I._SINGLE-WALLED [:12.DOUBLE.WALLED 49043 <br /> IF IDOUBLE WALLED- —— <br /> UDCINTERSTITIAL I�MLI)LQ 49Ma— <br /> !Lnm— _R P2 I 1Y. 1.Ll �LLJD 2.1&--LURE <br /> _ _._Q_ 9 _ <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT'OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS 0 a.YES El b.NO - 490-&b <br /> VII.PERIODIC SYSTEM TESTING <br /> jT0L—DTEsTiNG: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES— -----'UO- THAT-CNIIANg;CQ --4906-5 <br /> .AD I �'LD CONTROL ARD <br /> M11S.11-E—EPE:RFORMED. PERIODIC ELD IS-PERFORMED EVERY 36-MONTHS AS!tEQUI RqQ,(11CIZJ�12644.1 1 <br /> P(2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS 490.66 <br /> 3.SPILL BEIC'KETS 1,E TED ALL <br /> vr <br /> 415*007 <br /> Vt11.RECORDKEEPING <br /> The following monitoring/maintenance records are kept for this facility: — <br /> Na Alarm logs 4"_68a 19Visual Inspection Records 49048h 0 Tank integrity testing results 490-68C <br /> V9 <br /> 15 J0 SIR testing results(and supporting documentation records). 49o-6,d [j Tank gauging results(and supporting documentation records). 490."a <br /> ATG Testing results(and supporting documentation records).49o.68t [I Corrosion Protection 60-day logs 490.6sa <br /> J&Equipment maintenance and calibration records, 490.62h <br /> IX.TRAINING <br /> Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 49s69a <br /> FERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) <br /> 21 THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)49a69b <br /> OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490.69. <br /> CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d <br /> CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-69, <br /> ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS MANUAL AND <br /> STATISTICAL INVENTORY RECONCILIATION"490-69f <br /> SWRCH PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"4".ft <br /> OTHER(Spec*):m69hM6% <br /> facilityThis has who has passed the ICalifornia UST System Operator Exam administered by the ll i ii,ii,i i nl Code Council(ICC). <br /> he"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: ��l <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.4go-7o <br /> X. COMMENTS)ADDITIONAL INFORMATION <br /> Provide n­dd_i1i,_)na­1-_-m-_a_nts her.or�jncrjcaje h.,y many Pages with additional information on specille monitoring procedures are attached to this plan.490-71 <br /> <- <br /> pERSONNTI L RESPONSIBILITIES <br /> The UST Owner/Operator is responsible for ensuring that: 1)the daily/routine us'r monitoring activities'and maintenance of UST leak detection equipment covered by <br /> this Plan occurs,2)all conditions that indictile a Possible release are investigated,and 3)all monitoring records are maintained properly. <br /> r The following person(s)are respond hie for performing the monitoring and equipment maintenance- <br /> NAME <br /> NAME 4M*CTJTLE <br /> M- 490-7Aft'n1`F.P 4W73 <br /> The Designated Operator shall perform a monthly via re <br /> Ila -—.W?s <br /> conditions that need follow-up action. n3POc"On OF the flicility,provide a report to I owne operator,and inform the ownertoperator of <br /> any <br /> X11 OWNERIOPERATOR SIGNATURE <br /> CERTIFICATION.I certify that the Information Provided herein is true and accurate to the best of my knowledge. <br /> (!7_1 490-76 DA 490-77 <br /> I d%ft <br /> _B=M=a2_- <br /> ,o <br /> APPLICANT NAME(print). <br /> 4M79 <br /> _A <br /> EA_T L14% PPLICANT T o 490-79O <br /> C) P-Q,� <br /> UPCF UST-D(122007)314 <br />