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UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN—(PaLe 2 of 2) <br /> VI. ER DISPENSER CONTAINMENT(UDC)MONITORING that(Chert all <br /> UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) <br /> ® 1.CONTINUOUS ELECTRONIC MONITORING ❑ 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 490-544 <br /> ❑ 4.NO DISPENSERS ❑ 99.OTHER(Specify) 490"546 <br /> LEAK MONITOR MANUFACTURER:Beaudreau 4W55_ MODEL#:TLS-35OR 49056' <br /> LEAK SENSOR MANUFACTURER:Beaudreau 49-57. MODEL#(S):406/508 490,38 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. ® a.YES ❑ b.NO 49o.59 <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑ b.NO 490-60. <br /> FAILUREIDISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑ b.NO 490,61. <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ® a.YES ❑ b.NO 490,62. <br /> UDC CONSTRUCTION IS: ® 1.SINGLE WALL ❑ 2.DOUBLE WALL 490.63' <br /> IF DOUBLE WALL: 4944a <br /> UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ a.LIQUID ❑ b.PRESSURE ❑ c.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. ❑ a.YES ❑ b.NO 490646. <br /> VII. PERIODIC SYSTEM TESTING <br /> 1.ELD TESTING:THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 49.65. <br /> LEAK DETECTION ELD <br /> j MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED.123 CCR 02644.11 <br /> ® 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490-66. <br /> ® 3.SPILL BUCKETS ARE TESTED ANNUALLY. 49M7. <br /> VIII. RECORD KEEPING <br /> The following monitoring/maintenanoe records are kept for this facility: 490.64 <br /> ® a.ALARM LOGS ❑ b.VISUAL INSPECTION RECORDS ❑ c.TANK INTEGRITY TESTING RESULTS <br /> ❑ d.SIR TESTING RESULTS(and supporting documentation records) ❑ e.TANK GAUGING RESULTS(and supporting documentation records) <br /> ❑ f.ATG TESTING RESULTS(and supporting documentation records) ❑ g.CORROSION PROTECTION 60-DAY LOGS <br /> ® h.EQUIPMENT MAINTENANCE AND CALIBRATION RECORDS <br /> IX. TRAINING <br /> ® Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties: 4904% <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY:- (Check all that apply) <br /> ®THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 490-M <br /> ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) 490.69¢ <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-M. <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 490.6%. <br /> ❑STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND 490-W <br /> STATISTICAL INVENTORY RECONCILIATION" <br /> ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 49"9s. <br /> ❑ OTHER(Specify): 4904% <br /> 4904% <br /> This facility has a"Designated UST Operator"who has passel the California UST System Operator Exam administered by the International Code Council 490-70. <br /> (ICC). Tice "Designated UST Operator"will train facility employees in the proper operation and maintenance of the UST systems annually,and within 30 <br /> days of hire.This 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 facilityemployee's role with regard to spills and overfills as specified in the facility's UST Response Plan. <br /> ➢ Name(s)of contact person(s)for emergencies and monitoring alarms. <br /> X. COMNTS/ADDITIONAL INFORMATION <br /> Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan. 490-71 <br /> Fill Sump Sensors:Veeder Root 794380-208 87 and 91 Turbine Sumps have 352 Sensors <br /> Overfill Protection: Drop Tube Flapper DSL and 89 Turbine Sumps have 208 Sensors <br /> XI. PERSONNEL RESPONSIBILITIES <br /> The UST Owner/Operator is responsible for ensuring that: l.)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment covered <br /> by this plan occurs;2. all conditions that indicate a nsible release are investigated;and 3.)all monitoring records are maintained Mperly. <br /> THE FOLLOWING PERSON(S)ARE RESPONSIBLE FOR PERFORMING THE MONITORING AND EQUIPMENT MAINTENANCE: <br /> NAME: Manan Arlvari 49072. TITLE:Area Mananer 490'73, <br /> NAME: Summer Ireife 490-74. TITLE:General Manager 090,75 <br /> The Designated UST Operator shalt 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 action. <br /> XII. OWNER/OPERATOR SIGNATURE <br /> CERTIFICATION:[SLrti <br /> :fy that the information provided herein is true and accurate to the best of my knowledge. <br /> APPLICANT SIGNATURE DATE: 49x77. <br /> 7/19/2010 <br /> REPRESENTING: 1,Yank 2.Reiliu Owner w .Anth6tiaed ive of Owner 490-76. <br /> UPCI:UST-D(12/2007)-3/$ www.unido c org <br />