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UNIFIED PROGRAM CONSOLIDATED FORW <br /> r UNDERGROUND STORAGE TANK <br /> MONITORING PLAN (Page 2 of 2) <br /> VI.UMER DISPENSM CONT"AHM"0 MONITORING <br /> L UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-54a <br /> A I.CONTINUOUS ELECTRONIC MONITORING 0 2.FLOAT AND CHAIN ASSEMBLY 0 3.ELECTRONIC STAND-ALONE 490-546 <br /> 0 4.NO DISPENSERS 099.OTHER(SWifX):___ <br /> PANEL MANUFACTURER: �(,r-e OLU, 490-55 50 490-56. <br /> LEAK SENSOR MANUFACTURER 490-11 1 MODEL#(S): 490-58 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS A a.YES [3 b.NO 49D,19 <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN 1z a.YES [3 b.NO 490-60. <br /> FAILURE/DISCONNECTION OF UDC MONITORING S.-iTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. YES 0 b.NO j,YES 49"1 <br /> UDC MONITORING STOPS THE FLOW OF PRODUI �T THE DISPENSER. b.NO 490.62 <br /> 2.UDC CONSTRUCTION is SINGLE-WALLED OUBLE-WALLED 49043 <br /> IF DOUBLE WALLED: 490-"a <br /> UDC INTERSTITIAL SPACE IS MONITORED By. 1.LIQUID [3 2.PRESSURE [3 3.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS [3&YES [I b NO 4%.4b <br /> VII.PERIODIC S"TEM TESTING <br /> V THAT�� 4-5. <br /> 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD I <br /> 2ZMC=MLD)MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED.(23 CCR 2644.1 <br /> SECONDARY CONTAINMENT COMPONENTS AM TESTED EVERY 36 MONTHS. 490-66 <br /> 3.SPILL BUCKET'S ARE TESTED ANNUALLY. -- 490-67 <br /> - VIII.EE2!"1ICUPING <br /> following momiaring/maintenance records are kept for this facility: <br /> arm logs 490-68a 0 Visual Inspection Records 490-686 )u*integrity testing results 4w*8c <br /> :sting results(and supporting documentation records). 490-M 'ank gauging results(and supporting documentation records). 49"u <br /> Testing results(and supporting documentation records).4906af corrosion Protection 60-day logs 49008 <br /> uipment maintenance and calibration records. 49068h <br /> IX TRAIN]NG <br /> el with UST monitoring responsibilities are familiar with all of the following docurnents relevant to their job duties. 490-69a <br /> Personnel <br /> DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) <br /> THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)4w-69b <br /> H <br /> OPERATING <br /> PERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)49"k <br /> P1 <br /> C C <br /> ALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49o-69d <br /> CALIFORNIA UNDERGROUND STORAGE TANK LAW 49D4i4e <br /> 0 STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS MANUAL AND <br /> STATISTICAL INVENTORY RECONCILIATION"490-W <br /> [3 SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"4go-69g <br /> [3 OTHER(Specify):MWk M69i <br /> 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.490-7o <br /> X CONEWENTWADDITIONAL INFORMATION <br /> Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan.49o-7i <br /> D has -)::7l e 9 1 ho,0e C1'r4,k,,r, droof, 0 <br /> V V XL PERSONP&LAUPONSIBIUIUS <br /> The UST Owner/Operator is responsible for ensuring that:1)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment Jeovered 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'I=X 490.-73 <br /> NAME 49o-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 /> XHA)NMRIOPERATORSIGNATUM <br /> ----Z <br /> CERTMCATIO�k:f�"fytheAtheinfomoWn rovided herein is true and accurate to the best of my,1mg4led ge. <br /> APPLICANT S N 49076 DATE: 490-77 <br /> 0�/o <br /> Dazt.-0 Z Fadfity Qw=ffi2M= El 3 AgthM-A R=MepWin pfoM <br /> APPLICANT N�"rim): awn APPLICANT T 490-79 <br /> P <br /> UPCF UST-D(IMMIn 3/4 7--7 <br />