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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 <br />490.54a <br />490.546 <br />® 1. CONTINUOUS ELECTRONIC MONITORING 1:12. FLOAT AND CHAIN ASSEMBLY ❑ 3. ELECTRONIC STAND-ALONE <br />❑ 4. NO DISPENSERS ❑ 99. OTHER (Specify): <br />PANEL MANUFACTURER: Veeder Root 490.55 1 MODEL #: TLS -350 <br />490.56. <br />-------- ------ - ------ - ---- - --------------------•--------------- -- ---------- - ------ - ----- - <br />LEAK SENSOR MANUFACTURER: Veeder Root 490 57 MODEL #(S): 794380-208 <br />490-58 <br />DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ® a. YES ❑ b. NO <br />490-59 <br />UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ® a. YES ❑ b. NO <br />490-60. <br />FAILURE / DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a. YES ❑ b. NO <br />490.61 <br />UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ❑ a. YES ® b. NO <br />490-62 <br />2. UDC CONSTRUCTION IS ® 1. SINGLE -WALLED ❑ 2. DOUBLE -WALLED <br />490-63 <br />IF DOUBLE WALLED: <br />490-64a <br />UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ 1. LIQUID ❑ 2. PRESSURE [13. VACUUM <br />A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑ a. YES ❑ b. NO <br />490.646 <br />VII. PERIODIC SYSTEM TESTING <br />❑ 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED <br />490-65. <br />LEAK DETECTION ELD MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS RE UIRED. 23 CCR 2644.1 <br />® 2. SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. <br />490-66 <br />® 3. SPILL BUCKETS ARE TESTED ANNUALLY. <br />490-67 <br />VIII. RECORDKEEPING <br />The following monitoring/maintenance records are kept for this facility: <br />® Alarm logs 490-68a ❑ Visual Inspection Records 490-68b ❑ Tank integrity testing results 490-68c <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 490-68g <br />® Equipment maintenance and calibration records. 490-68h <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 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 />❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d <br />❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-696 <br />❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND <br />STATISTICAL INVENTORY RECONCILIATION' 490-691' <br />❑ SWRCB PUBLICATION: "UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 490-69g <br />❑ 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. 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 attached to this plan. 490-71 <br />There is a Mechanical Overfill device installed on this system set at 95% of capacity. <br />OMNTEC Tank Gauging used for inventory reconciliation on all tanks. <br />XL 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 Edna Huck 490-72 TITLE General Manager 490-73 <br />NAME Joey Cupp 490-74 TITLE Environmental Mgr 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 />XII. OWNER/OPERATOR SIGNATURE <br />CERTIFICATION: I certify that the information provided herein is true and accurate to the best of my knowledge. <br />APPLICANT SIG a9a-76 <br />DATE: <br />490-771 <br />D <br />APPL]Ci&T NAME (print): 490-78 <br />APPLICANT TITLE: <br />490-79 <br />Joey Cupp <br />Environment Management <br />UPCF UST -D (12/2007) 8/23 <br />