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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGRC UND TQRAGE TANK MONITORING PLAN—JPaLe 2 of 2) tcheot VI.UNDER DISPENSERC61TAIRIIVIE (LTC} GNITt3� l�G �' thw 4001W UDC MONITORING IS PERFORMED USING THE FOI.LCIWING METHOD(S) I.CONTINUOUS ELECTRONIC MONITORING ❑ 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 00-5ea. 490-54b. ® 4,NO DISPENSERS ❑ r3u OTHER(Specifv) .._ - �� 4�.stz LEAK MONITOR MAN ' vee des ROat MC)DE�L#: Tt:s- o a E✓FAC'Tt,RER: VOeder Root 4`90`47 MODEL t€.(S):Zoe LF AK SENSOR MAL%LFACTURER. DET[: [ION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE:AND VISUAL ALARMS, a,YES ❑ b.No 41,10-19, UDC LEAK ALARM TRIGGERS AUTOMATIC OMATIC PUMP SHUTDOWN, a.YES ❑ b.No 440-1,0 FAII.URL;fDISCONNECI'ICLFNI C3L'F.;DC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN, a.YES ❑ b.ND 490-61, UDC MONITORING STOPS THE FLOW OF PRODUCT ATTHE HE DISPENSEER, ❑ a.YES ❑ b.No 491-62, UDC CONSTRUCTION ON IS� ® I.SINGLE_WAIL ❑ 2.DOUBLE,WALL W1: 49C,64a, AL UDC"INTERSTITIAL SPACE;IS MONITORED BY ❑ a.LIQUIll:i ❑ b PRESSURE ❑ c VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE LDC TRIGGERS AUDIBLE'AND VISLIAL ALARMS. ❑ a.YES [I b.?tit) 490-64a 'SII. PERIODIC SYSTEM TESTING I. EI.D TEST€NG" THIS FACILITY HAS BEF*N NOTIFIED E3Y riw STATE WA'fI:R RESOURCEiS CONTROL BOAR€3 THAI E dSlrldvf'E>I) 4957— LEAK 95L"A D-Ft': N "..D MUS`r BE PI?Rl-'ORMED, PERIOD]C EL.D IS PERFORMED EVERY 36 MON-1-1 IS AS RI: I.I:RED,I23 CCR�2644 iI 2.SEC()NDAIZY CONTAINMENT Cf:MPONENTS ARE T"I S ED EVERY 36 MONTHS, 490-66 3,SPILT,BUCKE Ts ARE TESTED ANNUALLY. 4906 til. VIII. RECORD KEEPING The fallowing monitoringlmainte umce records are kept for this facility. 491.69 a.ALARM LOGS b,VISUAL iNSPE:C;TION RECORDS ❑ c.TANK INTFGRITY TESTING RESULTS d,SIR TESTING RESULTS(and supporting documentation records) ❑ e.TANK GAUGING RESULTS(and supporting documentation records) ❑ f ATG TESTING RESULTS(and supporting documentation records) ❑ g.CORROSION,PROTECTION 60-DAY LOGS E UII'ML:NT hEAINTI NANCE'.AN[) r1l,tE3RA'r[G)N Ri�Ct3RDs I IX' TRAINING Personnel with UST monitoring responsibilities area familiar with all of the following documents relevant to their job duties. 49a a9a REFERI'NCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 490-69b. OPERATING MANUALS FOR EI,i CTRONIC MONITORING EQUIPMENT(Required) 4"-6,X- 0 -k`X❑ CALIFORNIA UNDERGROUND STCRAOE TANK RE,' r6ULA IONI S 49t,-69d ❑ CALIFORNIA UND€.RGROUND STORAGE.TAINK LAW 49"%, ❑ STATE WATER RESOURCES CONTROL E30ARD (SWRCf3) PUBLICATION: "HANDBOOK FOR TANK OWNERS • MANUAL, AND 4W-69f. STATISTICAL INVENTORY RECONCILIATION" SWRCB PUBLICATIOM"UNDERSTANDING AUTOMATICTANK ANK GAUGING SYSTEMS" 469n96. 49(6 e�'I'HUc(frpecjfy). . R)4•ti9r:. This facility has a"Designated LIST Operator"who has}sassed tltc California UST System Operator Exam administered by the International Code Council 490.70 (ICC). The "Designated UST Operatoe'will train facility employees in the proper operation and maintenance of the UST systems annually,and within 30 days of hire.This training will include,,but is not limited to,the foliowmg: Operation of the usT systems in a manner consistent with the facility's best management practices. The facility employee's role with regard to the monitoring equipment as specified in this LIST Monitoring Flan, Y The facility employee's role with regard to spills and overfills as specified in the facility's UST Response Plan. Name(s)of contact person(s)for cmergencies and monitoring alarms. X. COMMENTSADDITIONAL INFORMATION Provide.additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan. 4W-7i Currently the site has over fill prevention of mechanical flappers set at 95%of tank capacity. I. PERSONNEL RESPONSIBILITIES The UST Owner/Operator is responsible for ensuring that. L)the daily/routine LIST monitoring activities and maintenance-of Icak detection equipment covered by thi3 plan occurs;2.)all wnditions that indicate a possible release are investigated and 3)all monitoring record,,are maintained properly. THE:FOLLOWING PERSON(S)ARE RESPONSIBLE FOR PERFORMING THE MONITORING AND EQUIPMENT MAINTT NANC E,: NAME: Allen Faass 4<*'?-. TITLE: CompliancafMaintenance 4K fi3. NAM'.: 490-74 TITLE; 4Aa75. The.Designated UST Operator shall perform a monthly visual inspection of the facility,provide a report to the owner/operator,and inform the owner/operator of any conditions that need foilow-u acticm. .XII. OWNEPJOPERATOR SIGNATURE CERTIFICATION:I certify that the information roaided herein is trite and accurate to the best of m knowledge. APPLICANTSIGNATURE Dtt'T`h_ 4s t".RR85 SSFlA:U", t 'E'an3:Uurse'C„i tower 2 1=sitar t3kvntz'o ecu 3.hxothbrsz 3 _a�.amcivc of CJ+vi+4r 49tF 36.: APPLICANT NAME(print)° ��`�� APPLIC-ANT TITLE_ 4��, Allen Faass Compl Compliance UPCE UST-D(1212007)-3/d www.unidocs org