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t UNIFIED PROGRAM CONSOLIDATED FORM <br /> r 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 490-34` <br /> 490-sab <br /> 1.CONTINUOUS ELECTRONIC MONITORING ❑2.FLOAT AND CHAIN ASSEMBLY [13.ELECTRONIC STAND-ALONE <br /> ❑4.NO DISPENSERS [199.OTHER S cci ): <br /> PANEL MANUFACTURER:Veeder-Root 490-33 MODEL#-. TLS-35OR 490.$6. <br /> LEAK SENSOR MANUFACTURER:Veeder-Root 490-57 MODEL#(S):7943W-323 490-58 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS 0 a.YES ❑b.NO 490-59 <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN Il• LYES 0 b.NO 490.60. <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. N s.YES ❑b.NO 490-61 <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER N a.YES ❑b.NO 490.0 <br /> 2.UDC CONSTRUCTION IS ❑L SINGLE-WALLED M 2.DOUBLE-WALLED 490.63 <br /> IF DOUBLE WALLED: 490-64a <br /> UDC INTERSTITIAL SPACE IS MONITORED BY:E 1.LIQUID ❑2.PRESSURE ❑3.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS a.YES ❑b.NO 4"-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 /> MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED. 23 CCR 2644.1 <br /> ❑2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490.66 <br /> 3.SPILL BUCKETS ARE TESTED ANNUALLY. 490.67 <br /> VIII.RECORDKEEPING <br /> The following monitoring/maintenance records are kept for this facility: <br /> Alarm logs 490.680- ■Visual Inspection Records 490.68b ❑Tank integrity testing results 49a68c <br /> SIR testing results(and supporting documentation records). 490-68d ❑ Tank gauging results(and supporting documentation records). 490-68e <br /> ❑ATG Testing results(and supporting documentation records).490-68f ❑ Corrosion Protection 60-day logs 490.688 <br /> Equipment maintenance and calibration records. 49o4m <br /> IX.TRAINING <br /> 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 FACIL"(Check all that apply) <br /> THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490.696 <br /> OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490-690 <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"490-698 <br /> ❑ OTHER(Specify):M69%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 /> e"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 attachedd to this plan.490-71 <br /> Audible and visual overfill alarm set at 90%of tank capacity for overfill protection. <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 Dennis Bock 490-72 TITLE Environmental Compliance Manager 490-73 <br /> NAME Tim Hurlocker 49x74 TITLE Director of Gasoline Operations 49o-73 <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 /> XIL OWNER/OPERATOR SIGNATURE <br /> CERTIFICATION:I certify that the infortnation provided herein is true and accurate to the best ofmy knowledge. <br /> APPLICANT SIGNATURE 49o•76 DATE: 490-77 <br /> 1 [7 13 <br /> i.T..k Ownc,10waW <br /> APPLICANT NAME(print): 490-79 APPLICANT TITLE: 490-79 <br /> David H Rogers Director of Real Estate Development <br /> I1PCF rrsT-D(127287)3/4 <br />