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NOTED PROGRAM CONSOLIDATED FORA UNDERGROUND STORAGETANK MONITORING PLAN (Pegs 2 of2) VI.UNDER DISPENSER CONTAINMENT_ (UDC)MONITORING 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING+ME'f110D ~4b R L CONTINUOUS FLECIRONIC.MONr10RING ❑2.FLOAT AND CHAIN ASSEMBLY ❑ 3.FLEC'I'RONIC STAND-ALONF. L7-0 NO DISPENSERS ❑99 OI IIfR(SQccd)) PANEL MANUFACTURER VEEDER ROOT {°ass MODLLd TLS_35011 " - 490,96. LEAK SENSOR MANUFACTURER:VEEDER ROOT {9asr MODEL N(S).794380-323—_ 49a5n DETECTION OF A LEAK INTO TI IE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS - 0 w YES ❑b.NO 49669 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP Si IUTDOWN ®a.YES ❑b.NO 4966 FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. 9 a.YES ❑Ir.NO 49"l UDC MONI'1'ORINGSTOPS'I'IlliFLOWOFPRODUCT ATTIIt:DISPENSER.: ® a,YES ❑b.NO 40,060 2.UDC CONSTRlIC`fION IS 0I.SINGLE-WALLED tM 2.DOUBLE-WALLED woes IFDOUIiLF WALLED: UAC IMERSTITIAL SPACE IS MONITORHU UY: ®f-LIQUID._•f]2_!?RLSSURE_❑3 VACUUM_•_-..• __ _.... ____,_.__,_;....... ALEAKWITHINTHESECONDAR_YCONTAINMENTOPTHEUDCTRIGGERSAUDIBLEANDVISUALALARM_S_ IR YF.S ❑b.NO 49e-616 VII;PERIODIC SYSTEM TESTING 1. ELD TESTING-THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENI IANCEU 4"45 LE . ION 1 -LD)MUST BE PLRf ORMPI). PLRIODIC ELD IS PERF ORM_F.D EVERY 36 MONTI IS AS R_F.QI IRLD (2i CCR a26i 1) _ __• ❑2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS, {90-M ayr .................._-...............--"----.............____..__..._.:_ tat 3.SPI LL BUCKETS ARF.TESTED ANNUALLY. .490467 VIII.RECORDKEEPING Talie rollowing monhoringArmintemuce records are kept for this facility: El Alnfm logs 4W(Ala ❑Visual Inspection Records 49e6b ❑Tank integrity testing results 49o-wa ❑SIR testing results(mid supporting documentation records). 490asd ❑ Tmtk gauging results(and supporting docomentnlion records). 49"se ❑ATO Testing results(rnd supporting documentation records).490431' ❑ Corrosion Protection 60-day togs 490426 14 Equipment maintenance and calibration records. 49aash —]7f TRAINING — 0 Personnel with UST monitort ig responsibilities are familiar with all of the Ibilowing documents relevant to Utck joh(kdies.1490,69. REFERENCE DOCUMENTS MAINTAINED AT FACILITY?(Check all that npply) ® '"IIS UNDERGROUND STORAOE TANK MONITORING PLAN(Requircd)499Nrb OPERATING MANUALS FOR ELECTRONIC MONIIORINO EQUIPMENT(Required)490-W9 ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS49a69d ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 49-690 ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR `TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION-409-691' ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMXrIC'fANK GAUGING SYSTEMS"49aa69g ❑.O'riIFR(Specify):u696.6r6% This facility has a"Designated UST Operator'who passed the—Cal ifomin UST System Operator Exam administered by tire hncrnatlonal Code Council(ICC). The"Designnled USI'Opemlor"will Imin facility employees in the proper operation and maintenance of tine UST systems anounlly,and wilhin 30 days of hire.This training will includo,but is not limited to,the following: Y Operation oflho USTsyslenis in anianncr consislem with the facility's best management practices Y The facility employ'ee's role with regard to the manitoringegoipnncni as specified In this UST Monitoring Plan D The facility employee's role with regard to spills mrd overfills as specified in the UST Response Plan Y Nomesofconlac(person(s)forcniergencicsnndmonitorbtgatarms.490-70 X. COMMENTS/ADDITIONAL INFORMATION Provide additional comments hero or indicate how many pages with additional infommtiore on specific monitoring procedums are attached to this pla1T 44W71 1 PAGE SENSOR SUPPLEMENTAL FORM ATTACHED,AUDIBLE AND VISUAL OVERFILL ALARM SET AT 90%OF TANK CAPACITY XI.PERSONNEL RESPONSIBILITIES The US'r Owncr/Opemtor is responsible for ensuring(hat-,1)the daily/muRne UST monitoring activities and maintcnmrce of UST leak detection equipment covered by tilts plan occurs,2)all conditions Unit indicate a possible release am investigated,and 3)all monitoring records are HminIftiAW property. 'Hie fol lowing person(s)arc responsible for perrorming tire monitoring and equipment niabaw.vice: NAME.DENNIS DOCK 49042 TITLE COMPLIANCE MANAGER 490.7) NAMETIM HURLOCKER ITI'LE DIRECTOR OF GASOLINE OPERATIONS The Designated Operator shrill perform n monthly visual inspection of the facility,provide a report to the m ler/operatur,and inform the owner/operator of mry conditions lull need ficifow-pp.action. _ ^XU.OWNER/OPERATORSIGNATURE _ CERTIFICATION:I cerllf'that Rte infornudion provided heroin is true mid accurate to the best of my knowledge. APPLICANT SIGNATURE,- ,J ;� 490-76 DATE: 49077 !/,w—"it, Dt4-, 1 ` 0`t ", 1/7 13 ' O „n ❑ � .iv 9f. APPLICANTNAME(prinG' 490'71 APPLICANT TITLE: 4W9 DAVID H ROGERS DIRECTOR OF REAL ESTATE DEVELOPMENT