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Dec 05 10 11:57a Arco AMPM 2098308293 p.3 <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN—(Pa e 2 of 2) <br /> VI.UNDER DISPENSER CONTAINMENT (UDC) MONITORING (check all <br /> thalaPPI)l <br /> UDC MONITORING IS PERFORMED USING THE FOLLOWING METHODS) <br /> YI.CONTINUOUS ELECTRONIC MONITORING ❑ 2.FLOAT AND CHAIN ASSEMBLYy <br /> ❑ 4.NO]DISPENSERS ❑ 3.ELECTRONIC STAND-ALONE a9o•sa <br /> ❑ 99.OTHER(Specify) 490.54h <br /> LEAK MONITOR MANUFACTURER: V l✓D �L,-( 49-55. MODEL N: �'L- S SC .I90-56 <br /> LEAK SENSOR MANUFACTURER: h l J93-57. MODEL N(S):_ 3 3 -490-59.DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. ❑•"a.YES ❑ b_NO 40o-59. <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑ b.NO 49ato. <br /> FAILUREIDISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. IH a.YES ❑ b.NO 4911-61. <br /> _ _UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. a.YES ❑ b.NO `9"2- <br /> UDC CONSTRUCTION IS: ❑ 1.SINGLE WALL [] 2.DOUBLE WALL 490-63. <br /> IF DOUBLE WALL a9n64a <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 49"4b. <br /> VII. PERIODIC SYSTEM TESTING <br /> ❑ 1.ELD TESTNG: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 49"s. <br /> LEAK DETECT't N ELD MUST BE PERFORMED. PERIODIC ELD 1S PERFORMED EVERY 36 MONTHS AS REQUIRED.3'-3 ccR§2&W-11 <br /> ® 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. +9066. <br /> ® 3_SPILL BUCKETS ARE TESTED ANNUALLY. •19•,67. <br /> VIIL RECORD KEEPING <br /> The following monitoring/mafntenance records are kept for this facility: 497 <br /> ® a.ALARM LOGS ❑ b.VISUAL INSPECTION RECORDS [El-c.TANK INTEGRITY TESTING RESULTS <br /> ❑ d SIRTESTiNG 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: 49t,69. <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 LNDERGROU'ND STORAGE TANK REGULATIONS 490-69e <br /> ❑CALIFORNIA UNDERGROUND STORAGE TANK LAW 49"91 <br /> ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND 49r.69f <br /> STATISTICAL FNVENTORYRECONCILIATION" <br /> ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 49"q& <br /> ❑ OTHER(Specify): 490.696. <br /> ago-�.ai. <br /> ® This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council +M TO <br /> (ICC). The "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 facility employee's role with regard to spills and overfills as specified in the facility's UST Response Plan. <br /> > Name(s)of contact persons)for emergencies and monitoring alarms. <br /> X: COMMENTS/ADDITIONAL INFORMATION <br /> Provide additional comments here or indicate how many pa es with additional information on specific monitoring procedures are attached to this plan, 490-71. <br /> Ip <br /> V! <br /> i`S(�( v t , <br /> XI. 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 <br /> by this plan occurs;2.)all conditions that indicate a possible release are investigated;and 3j all monitorin records an maintained�Iroperly. <br /> THE FOLLOWING PERSON(S)ARE RESPONSIBLE FOR PERFORMING THE MONITORING AND ETIPMENT NIAINT NCE: <br /> NAME: f�(� —J F— -T —Sl Al yam! � 7'- TITLE: r 1 <br /> �,7 C�. f l.t—(V 69043. <br /> NAME: +�/KA-ft7yl 7 s)j�(!I'f ago ly, TITLE: 496.75. <br /> The Designated UST Operator shall perform a monthly visual inspection of the facility,provide a report to the ownedoperator,and inform the ownerioperator of any <br /> conditions that need follow-up action. <br /> XIL OWNERIOPERATOR SIGNATURE <br /> CERTIFICATION.I certify that the information provided herein is true and accurate to the best of my knowledge. <br /> APPLICANT SIGNATURE = DATE: I 490.77. <br /> REPRESENTING;0 1.Tont 0. gator 2.Faalih Oxnel� ;or❑3.Ao,hori<ed reseamiuo of Owner Jx,-7R. <br /> 4.1V/tl. <br /> AYYLICANI'NAME(pniat): APPI-ICANTTITLE; tvo-r�• <br /> _Vic L <br /> UPCF UST-D(1212007)-314 www.unidocs.org <br /> ,*"I ,zz /-/�/i <br />