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UNIFIED PROGRAM CONSOLIDATED FORM <br />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 4900-544490-54b <br />1. CONTINUOUS ELECTRONIC MONITORING E] 2, FLOAT AND CHAIN ASSEMBLY E] 3. ELECTRONIC STAND-ALONE <br />❑ 4. NO DISPENSERS ❑ 99. OTHER �§.pci.fyt. . ...... — --------- — --- --------- <br />-- - - ----- 490-56. <br />522T <br />PANEL MANUFACTURER: Beaudreau NW66EL <br />- — ---- — -------- — ------- <br />...... -------------------------------------------- - <br />LEAK SENSOR MANUFACTURER: Beaudreau 49"' 1 MODEL #(s): EOS100 490-58 <br />DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS YES 0 b. NO 490-59 <br />UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN YES 0 b. NO 490-60, <br />FAILURE / DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN, YES ❑ b. NO 490-61 <br />UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. YES ❑ b, NO 490-62 <br />2. UDC CONSTRUCTION IS [911. SINGLE -WALLED ❑ 2, DOUBLE -WALLED 490-63 <br />IF DOUBLE WALLED: 490-644- <br />LIQUID2. PRESSURE El 3. VACUUM ---______•__-_-_-•_________________---__----___----_-__ <br />UDC INTERSTITIAL SPACE IS MONITORED BY: 1. LIQUID F-1 - <br />-------- - ------- --- -- - <br />A LEAK THIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLB AND VISUAL ALARMS Ela,YES [1b.NO _490-64b <br />WI <br />VII. PERIODIC SYSTEM TESTING <br />El 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROLBOARDTHAT ENHANCED 490-65. <br />Plyjj�:EBE PERFORMED. PERIODIC ELDJS PERFORMED EVERY 36 MONTHS AS REQUIRED. (23 CCR <br />LEAK DETECTION (FEDI . ........ . ............ -----------§2644,1)-------------- <br />z 2. SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490.66 <br />Z 3. SPILL BUCK 7 <br />VIE. RECORDKEEPING <br />The following monitoring/maintenance records are kept for this facility: <br />2 Alarm logs 490-68a [I Visual Inspection Records 490-68b ❑ Tank integrity testing results 490-68c <br />[:1 SIR testing results (and supporting documentation records). 490-68d ❑ Tank gauging results (and supporting documentation records). 490-68a <br />* ATG Testing results (and supporting documentation records). 490-68f ❑ Corrosion Protection 60 -day logs 490-685 <br />* Equipment maintenance and calibration records. 490-68h <br />Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 490.694 <br />REFERENCE DOCUMENTS MAINTAINED AT FACILITY (Check all that apply) <br />THIS UNDERGROUND STORAGE TANK MONITORING PLAN (Required) 490-69b <br />OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT (Required) 490-69c <br />El CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490.69d <br />n CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-69. <br />n STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS MANUAL AND <br />STATISTICAL INVENTORY RECONCILIATION" 490-69F <br />❑ SWRCI3 PUBLICATION: "UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 490.698 <br />El OTHER (Specify): M69h, 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. 49o-70 <br />X. COMMENTS/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, Regular -IB Turbine Sump -208 <br />Regular, Plus and Premium tanks have two sump's with two turbine's / Sump sensors #794380-352 / Alarm set at 95% <br />XI, PERSONNELRESPONSIBILITIES <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 Mo an Manvari 490-72 TITLE Area Manager 490-73 <br />NAME Grant Zech 490-74TrrLE Operations Manager 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 />XIL OWNER/OPERATOR SIGNATURE <br />CERTIFIC4FION: I certify that t4 info mation provided herein is true and accurate to the best of my knowledge. <br />APPLICANTAfIGNATURE 4W76 <br />490-77 <br />DATE. <br />January 27, 2011 <br />ARM <br />APA490-78 <br />NAME (print): <br />T (A 1hirl, f FT, <br />APPLICANT TITLE 490-79 <br />APPLICANT <br />j)jjneQ 1 01/71ml <br />UST Response Plan (3/2008) 3/3 <br />