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07-14-10; 19,.26 12093684972 L*A:ED pRCavAM CONSOLDATED FOW STC ET LWNffl0RNGKM;C2jd2) vi.u DISPENSER CONTAINMENT MUC)NtONffMNG 1. UVC MONITORING IS PERFORMED USING THE FOLLOVVNMS METHOD 19 1. CONTINUOUS ELECTRONIC MONITORING 0 2.FLOAT AND CHAIN ASSEMBLY El 3.ELECTRONIC STAND-ALONE [3 4. NO DISPENSERS (3 99.OTHER(SpT! PANEL MANUFACTURER: Veeder-Ptwt MODELS: 77Z-350 LEAK SENSOR MANUFACTURER;Veeder-Ro49"7 Root MODEL#(S): 208 �ff T—50 DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS CK a* UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN 0 a YES 0 b.NO FAILIUREIDISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN 9 a-YES 0 b.NO Lm3r_MONITORING STOPS THE FLOW OF PRODUCT AT TELE DISPENSER a.YES 0 b.NO 4110-42 2. UPC-CC"TRUCTION 13 19 1.SINGLE-WALLED [1 2.DOUBLE-WALLEID IF DOUBLE WALLED: LIOC INTERSTITIAL SPACE 15 MONITORED BY' C) Z.LIQUID 0 2-PRESSURE [1 2.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ED a.YES 0 b.No VII. PERIODIC SVVMNI TEUTING 1. ELD TESTING: T"IS FACILITY "As BEEN NOTIFIED BY TM STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED L966 99047 CETECN(ELDIMLIST PERFORMED PERIODIC OCR S§44,1) -T MSECONDARY CONTAMINIIIIIENT C0111111PONENT5 ARE TESTED EVERY 36 MONTHS 490 ee 3- SPILL 13UCKETS ARE TESTM ANNUALLY is RECOM13KEEPING Tin folarift snonAoringilmairdanance records are kept for this tKittY: 10 Alarm lqp 490-67 N Visual Inspecildn Records 49048b El Tank IntagrityAearting ramilts. 49D-Oc J3 SIR Msitnit results(atilt supporting dwmentatim records). 49D.05d E3 -rank pwwq results(arid supporting clocumeraffian recerds)40-689 (3 ATG Testing rasubs,two suppwfmo doconevnedw recoWs). 490aBt OCarrosion Pfi63clion 604wf logs 4904BO 0 eqijipmeritmaintenance six!cabrobnm=ds- AN-MIN IX. TRAIIIIIIIING 181 Pewnrialwit"UsTntonli9mg tesponvilliciresale larnillar vAth so of the fanomftg obetraere mie-vantV their job MOOD& 4204i9s REFERENCE DOCUMENTS MAINTAINED AT FACILTV(Chatkall that apply) I@ THIS UWER131ROUNO STORAGE TANK MONITORING PLAW(RaWIMO) 49"911 0 OFUZATING MANUALS FOR ELECTRONIC MONITOFUNG EQUIPMENT(Required) 42"9c, 0 CALL FORmijkUNIDERGROUNDSTORACE TANK REGULATIOINIStRenuired)49049d 13 CAUFDRwjA UNDERGROUND STORAGE rANK LAW(RequWed)490-698 13 STATE WATER RESOURCES COMTROL BOARD(SWRCS)PUBLICATION-%4ANDBOOK FOR-SANK ONNERS-MANUAL AND STATISTICAL 04KNTCW RE)CtMILIATIOW(Required)400-69F CZ SWRce PUBLICATION:-U"DERSTANOIING AUTOMATIC TANK GAUGING SYSTEMS' 4W499 L3 OTWR 0 Thin facility teas adicsignated UST Operator"who has passed the Califorrda UST System Oporinator Exam sominKlered by the IntermilonalCode Council(10C). The*Designated UIST Operator"YAR train facility employees in the proper operation and maintenance clF the UST systems annuotly,and wWn 30 days of hire.Thin;training wily irmiude,but is nol.gritted to,the following' )o Opera cri of the UST systems in a manner consistent with the(WIII�S beat management Praw3m. )• ,The jaegft efflployee'j;role wAlh Mard to the monilafing equWmrd as specified In this UST Manitorull;Flart x- The laciply,employee-s tole with regard'10=Ift arid overfills as specliled in the UST Response Plan. > Names of cola r4MOLSj for MEMgnM and mentor!M amens. 490-70 X. COMMENTWADIDITIONAL.IWORF&ATION Pm,Ade additional cornmerits here at Indicate how many pages with additional Infamadw an speeft monitoring procedures are attached tothis plan. 491)-rl overflUprevmth!n for undergrmad swrage ii�w�is drwtubes with mecliaTilcal f!Efflffs set 9S%uveffiUEMM'U0n XL PERSONNEL RESPONS11111111111-MES covered by lWa plan The UST OweledOperaky is responsitele for onsurbV that 1)the deN~ UST ST nvoniturirV edivites and meirdow oiUST leak deleCV0ffCQu1Pment occurs.2)all mnditicAs that Indicate a D=IA9 release are Wwastipat8d,and 3)Qh monWry records we m8ints4ned prolmly. Tho 50owing v=soj are rEMnift For jErlam1the murrilmi2jil MW g9womelt stlairftnaAce. JIVU- 49D- 3 NAme: Ewe S"u 72 TrfLE: Manager 1 - 400-75 '"o- I TITLE- managAi Member NAME: Kasivnif Sirigh TA tieDe-signaled Operator shall performs rnordvIyArial Inspection RFe-bzlllty,1110VIllea mParitomeownerlopendar.sridinbrmibouwrieritpwatwolgoyCond100n$UW. need killow-up eaton XII. OWNERIOPERATOR SIGNATURE C1111-CATION:I certify that the information pro i#ded herein is true End accurate to the best of my knowledge. 4M-77. APPLICANT SIGNATURE 4su-10 DATE! 4M -Tar14 APPLICANT Eddie APPLICANT NAVE(privit)., 490-74 APPLICANT TITLE: nilITZ' (print): Manager L-d