Laserfiche WebLink
• i <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORINGPLAN (Page2of2) <br /> VL UNDER DISPENSER CONTAINMENT(UDC)MONITORING <br /> ASW <br /> I. I DC MONITORING IS PERFORMED USING T#AVOLLOWING METHOD +acts <br /> ❑ 1 CONTINUOUS ELECTRONIC MONITORIN 2.-LOA'1AND CHAIN ASSEMBLY ❑ ).ELECTRONIC STAND-ALONE _ <br /> �! NODISPENSEI:OTHER LSLiaa-_.Ix�:_.__.�___._—.—. <br /> PANFI.MANUFACTURER: <br /> LFAKSENSORMANUFA_CfURER: <br /> DE'1 K r10N(IF A LEAK IN 10 THE UDC TRIOGERS AUDIBLE AND VISUAL ALARMS ❑a YES ❑b.NO +W,w <br /> ODC'LEAK AI.ARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ❑AYES 0b.NO + <br /> FAILURE/DISCONNECTION Of I IDC MONITORING SYSTEM TRK)OER.S AUTOMATIC PUMP SHUTDOWN. 13 ii.YES 0 I.NO <br /> UDC MONITORING 31 OPS THE FC OW OF PRODUCT AT THE DISPENSER j(,YES ❑b.NO +sut <br /> LI'DCC'ONSTRUCTIONIS SINGLE-WALLED ❑2.DOUSLEWALLFO +Wv <br /> IFDOU6L6 WALCED: — X97 <br /> ..UDC INTM%IITIAL SPACE IS MONITOREDBV: LL_ UM 2P�ESSURE_a3.VA000M <br /> _AtTEAK WIOIIN THE SECONDA_RYC_ONTAINMhNT OF THE UDCTRIGGFJIS AUDIBLE AND VISUALALARMS 0vYP3 ObNO <br /> VII.PERIODIC SYSTEM TESTING <br /> ❑ <br /> r ELD TEST NG.THIS FACILITY IIAS BEEN NOTIFIED BY TH9 STATE WATE.RFSOUkU CON'rILOI BOARD'f11AT ENHANCED T <br /> LEAK D�(E[TION(E.ID)MUST 8E PCR FORMED. PERIODIC ELD IS PERFORMfLgMTR.XAMONfHSAS- UIRED.(D CCR#2644.IZ, <br /> 'SFC'ONDARY CONTAINMENT COMPONEM ARE TESTED EVERY 36 MONTHS <br /> _J SPILL BUC KETS ARBTESfF,D ANNUALLY. <br /> VIIL RECORDKEEPING <br /> �Th.yu�Ibllowmg marks mgim.nlenaKe records are kelt Pm this facility. <br /> cat Ali m10gs +awes Q$Viool Inspection Records nwaa ❑Tank mrawaY resting lmulH+ssaa< <br /> ❑SIR usamitme.14(and opparrmgdocummu Ian records) +w++e ❑Tukptigingrmuln(wOluWrongdocumeeutionrtcords). +wore. <br /> ❑ATG Teaingresults(ad supporting documentation maords). mm ❑ Cormsian PreeWon 61 100 <br /> ❑Equipment maintenance and eallbralwn records.arae <br /> DL.TRAINING <br /> Pennlmal with US'r monitoring mponsibilnies an familiar with all of the following doemRn4 rola toil to theil'Alktie +D!+4 <br /> REFIiRENCE DOCUMWVIS MAINTAINED AT FACILITY(Check all chat apply) <br /> 7,THIS UNDERGROUND S70RAGE TANK MONITORING PLAN(Rrymrd)+eesa <br /> OPERATING MANUALS FOR ELECTRONIC MONITORING E.QUIPMENT(Reqund)•lasas <br /> CALIFORNIA UNDERGROUND STORAGE TANK REGULA TIONS <br /> FCA <br /> +awro <br /> CALIFORNIA UNDERGROUND STORAGE TANK LAW+was <br /> XSrATF WATER RESOURCES CONTROL BOARD fSWRCB) PUBLIC'AIION: "HANDBOOK FOR TANK OWNERS MANUAL AND <br /> STATISTICAL INVENTORY RF:CONCIUAIION +.cox <br /> OT SW RCB PUBLICA'I ION:'UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS'a <br /> OTHER(Speoifyl:Maw acnes <br /> I Ilia IacditY has a`Umlgnamd UST Operates'who has passed he Cuifwnn UST Sritam Down"Paam admmwad by Ne Into-Woo Coda Cawa:d UCC). <br /> i1Nll <br /> ' aigmted USI'Operator'will win facility,mpti yes in the mope operation ad maintenance of die USI'ays4!m enmally and wetha 30 days of him.Thu <br /> wining will mclmk.but is not limited w the following: <br /> Opemwn ol'tae I)SI'aymems m a mmn wmistem wish tM r eilWs bet mmagemmt pm iem <br /> lMc Wiityamploym-3m[emthre MWthvmoniWrin$ Wit intpeufiedm NistATManiaoring Plan <br /> + The fpcibly employee's role with rapid W spill,and overRlls.steadied m the UST WPmw Han <br /> Nar s ofwnhcl persdnU)for am%== motioning alamn.+Alen <br /> X._C_OMMENT ADDITIONAL INFORMATION _ <br /> FrorMe addmle�mfl�conmmts here carindicate Cow,many peg.with addi amid mfa1miMM 00 IPXfflC;Gjm wing promclM wattsehed m Uia Pim—11 <br /> Flapper Co e,( 1, <br /> I.PERSONNEL RESPONSIBILITIES <br /> IM LIS t Own mOpemWr is mspumible far cmunng than 1)the dallyhouNtw UST mmdrmi;aaNaias and mainemanm of UST 1mk dacaian equipment covered by <br /> this plan o¢un 21.11 conditions thin indicate a postblc namse arc imanpted.and J)all monitoring records arc maimunad prop ply <br /> Ihefoli.. stem ht+r f m momloiagadeapsomm in 0, <br /> NAME o m _ a2 +son TITLE +mu <br /> NAME +vol+TREE <br /> I ncD.egimed Olasator shall perfa I in 1) isuu impeai yf die DGItIY.P!n"'dD v rwrt the owns/weraor.ad infenn the awneAoftvatar of airy <br /> aasdOom Na need follow-uP Mticn.�yn `+�j <br /> XILOOWNERIOPERATOR SIGNATURE <br /> CFRTIF' .Anosi:Vg&tih&atthis in ed accurate to the ben of my knowliudge <br /> C SIONA f. nota DAT[ 'w'ar <br /> X .1,far A11510 <br /> APPI.ICANTNAMr.Umnt ss ///^��� APPLICANT TITLE 1°oN <br /> L'PC'P P5f-D(IMW'>)7M /"w /1/r LE <br />