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UNIFIED PROGRAM CONSOLIDATED FORM <br /> tTNT)V,R(.'R0(JND STORAGE TANK <br /> MONITORING PLAN –�P <br /> W, 11 Ile 2 of 2 (Check an <br /> VT.UNDER DISPENSER CONTAINMENT' (UDC)MONITORING thaggg&L <br /> UDCONITORINOISPERFORMEDUSIN-G THE FOLLOWING MEI'HOD(S) [3 3.ELECTRONIC STAND-ALONE 490-54L <br /> al.CON'I-INOC)USELE,(."'fRONICMoNl'fORING 2,FLOAT ANDCHAIN ASSEMBLY 4,x).54b. <br /> IEF,(31mudy) <br /> DISPENSERS (3 OTHER <br /> LEAK MO'NiTOR MANUFACTURER: MODEL *58. <br /> LEAK SENSOR MANUFACIVRER: MODEL <br /> DETECTION OF A LEAK IN-1-0 THE ULK: I KIGGIFIt.5 AUD113LC AND V13tJAL ALARMS. VES 0 b.Nn 49049. <br /> IJDC LEAK AI.ARM*TRIGGERS AU`rOMATTC PUMP SHUTDOWN. YES ❑ b.NO <br /> FAILTJRFJDISCONNECTION OI,UDC MONITORING SYSTEM TRIGGERS Alj*l'OMA rIC PUMP SHUTDOWN, R] a.YES b NO <br /> ,yLis b.T-4n <br /> UDC MONITORING STOPS'l IlIJ'l-I,()W CJF PRODwUCT A f THE DISPENSEK. ...2... <br /> f-1 2,IX)Ul3LL`WAIA- <br /> TR C76NS'T'RIJCTI0N ISi %L1.SINGLF WALL 4"A <br /> LF DPUWL_WALL. <br /> UDC INTP.M1,TITIAL SPACE.IS M0NiT0kr1r.*BY: 171 b,PRESSURE c.VACLAIM <br /> A LFAK wrrilIN THE SECONDARY CONTAINMENT OFTRL-,UDC TRIGGERS AUDIS LF AND VISUAL ALARMS. ❑ 3,YES El b.NO <br /> PERIODIC SYSTEM TESTING <br /> ❑ i.r.LD TE-Offl-NO: 1-1419 fACILITY HAS RFFN N(yriFIED Ry THE STATL WATER RESOURCES CONTROL BOARD THAT LNIIANCE 4!XW. <br /> LEAK DFTEC*I' FLD1 MUST RE PFRFORMt-0 PERIODIC L,'LLItSPERFORML-*DEVERY 36MON'I'IISASREOUIRL-1).t23era§aA4.11 <br /> 491W,6, <br /> 2.SECONDARY CONTAINMENT COMPONENTS ARL TESTED EVERY 36 MONTHS. 47V- <br /> 3. SPILL 1ZFKF:F;ARJ:Vy'L'-STFD ANNUALLY. <br /> VIII. RECORD KEEPING '190-69. <br /> The following M00itOTing/maintenance records am kept for this flicility: <br /> a.ALARM LOGS [I b.VISUAL lNsm-'CrION RECORDS 13 c,TANK(NTEGRITY'l-EsuNG RFSVLTS <br /> d.SIR TESTING RL,'SLJLTS(and suppottlog documentation tecoriti) 171 e.'I'ANN 0AI70IN0 RLSUT.,T5(and 3upportitlj$dacum*ntction nicofda) <br /> D f.ATC,TFSTING RESJILTS(and supporting documcniatiol,records) ❑ g.CORROSION PROTECTION 60-DAY LOGS <br /> b�FM�LNC NMAINTENANCE AND CALIBRATION RECORDS <br /> _ --- <br /> . _ <br /> LX. TRAINING <br /> Personnel with UST monitoring responsibilities are familiar with all of t1w following documents relcvant to their job duties; 49("% <br /> REL-IRENCF DOCUMENTS MAINTAINED AT FACILI'l Y(Check all that apply) 49"Qb. <br /> 0 THIS LINDERGROUNDSTORAGE TANK MONITORING PI..AN(Required) <br /> OPFRATINO MANUALS FOR LLECTRONIC yvj()?4rj-01kINrj EQVipmr.N1,(Roquirod) 49(w,-)e, <br /> ❑ CALIFORNIA UNDERGROUND STORAQE TANK ki:GUI.ATTONS <br /> E] CALIFORNIA UNT)FRGROUND STORAGETANK LAW <br /> D STATE, WATER RESOURCES CONTROL BOARD (SWRCB) KJBLICATION: "HANDBOOK fOR TANK OWNERS MANUAL AND <br /> "J'A 11, <br /> ,j h FILAL INVENTORY RECONCIT,.IAT70N <br /> rl SWRCB PUBLICATION:"UNDERSTANDING AUTOMAT`IC TANK GAUGING SYSTEMS" 49045" <br /> 13 OTHER(Specify) <br /> a HST System Operator Exam administered by the International cc&Council 490-70. <br /> proper operation and maintenance of the J;ST systems annually,and within 30 <br /> days Of here,This training will include,but is not 1 imitcd to,the following, <br /> Y Operation at'[hc UST Systems in a marttur consistent with the facility's hest managenwat practices. <br /> perifiml in IN-UST Monitoring Plan. <br /> The facility employee's tote with n Bard to spills and overtillS as speeilred in the facility's UST Response Plan. <br /> Names)0 <br /> X. COMMENTS/ADDITIONAL INFORMATION <br /> Provide additional coinmcnts here or indicate)iow many pages with additional igormation oo specific monitoring proccduV:s are amcncq to this plan. <br /> .04,00�<ifl;1110— 91� IAAk <br /> XL PERSONNEL RESPONSIBILITIES uxtion cquipmant Covered dc <br /> The UST OvvrwF/0,.t-r.11 for ensuring that: I )the daily/routine UST nx),111oring activities and n1dinw toaacc of UST IWk <br /> by this plan occurs.2.)all wilditions that indicate a possible release are iflvatiggcd;and 3.)all monitoring records are <br /> THE..FO F F.SPONSlL3 FOR PERFORMING THE MONITORING AND EQI.JIPMEN-l-MAINTENANCE: 49043, <br /> NAME: rITLILI: 490-75, <br /> NAME: TITLE:m h -- <br /> i 4 ility,provide a report to the ownc�/-o—peralor,and inforin the-owtier/operator of any <br /> The Designated UST Operator shall peftrm a monthly visual inspection of the ac <br /> conditions that need follow-9 action. OWNER/OPE- SIGNATURE <br /> CERTIFICATION:I certify-jarat the` ormatio rovi herein is t nd accurate to the best of flay knowledge, <br /> APPLICA:TS <br /> IUj <br /> NA <br /> 1tJKI, <br /> DATC: <br /> 4%.77. <br /> WDMG.�I T_ 2.Focality 0w.. <br /> AI'rLICAWT NAME <br /> (P".,). <br /> APPLICANTTITLE: <br /> Ir I C.- , <br /> U PC F UST.D(1212001)-314 www.unldoes.org <br />