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Ah Ah UNIFIED PROGRAM CONSOLIDATED FORMW UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VL UNDER DISPENSER CONTAINMENT (UDC) MONITORING 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 4o-54 V L CONTINUOUS ELECTRONIC MONITORING 112. FLOAT AND CHAIN ASSEMBLY 113. ELECTRONIC STAND-ALONE 4fl 54b ❑ 4. NO DISPENSERS ❑ 99. OT R S i ): PANEL MANUFACTURER: 490'33 MODEL!!: 49o-56. LEAK SENSOR MANUFACTURER: 490'57 MODEL g(S): 490.59 DETECTION OF A LEAK INTO THE UDC 11UGGERS AUDIBLE AND VISUAL ALARMS R a Y S ❑ b. NO 490'59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN E. a. YES ❑ b. NO 4040. FAILURE / DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. Q] a. YES ❑ It. NO 490'61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER Cr a. YES ❑ b. NO 4o-62 L UDC CONSTRUCTION IS ❑ L SINGLE -WALLED 2. DOUBLE -WALLED 490' IF DOUBLE WALLED: 490444 UDC INTERSTITIAL SPACE IS MONITORED BY: 0 1. LIQUID 2. PRESSURE 0 3. VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS [3a -YES ❑ b. NO 490446 VII. PERIODIC SYSTEM TESTING 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 49045 LEAK DETECTIONfflM MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED. 23 CCR 2644.1 ❑ 2. SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 49446 ❑ 3. SPILL BUCKETS ARE TESTED ANNUALLY. 490.67 VIII. RECORDKEEPING The following monitoring/maintenance records are kept for this facility: Alarm logs 49 sa Q Visual Inspection Records 40.69b ❑ Tank integrity testing results 40.6& ❑ SIR testing results (and supporting documentation records). 49 d ❑ Tank gauging results (and supporting documentation records). 490.69. ❑ ATG Testing results (and supporting documentation records). 4o49r ❑ Corrosion Protection 60 -day logs 4so.499 Equipment maintenance and calibration records. 490.69h IX. TRAINING ❑ Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to theirjob duties. 49o.69a REFERENCE DOCUMENTS MAINTAINED AT FACILITY (Check all that apply) THIS UNDERGROUND STORAGE TANK MONITORING PLAN (Required) 490496 OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT (Required) 49 % CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49a69d CALIFORNIA UNDERGROUND STORAGE TANK LAW 490497 ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCIIAATION" 4s0.69r ❑ SWRCB PUBLICATION: "UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 490499 ❑ OTHER (Specify): M691. M691 IQ This facility has a "Designated UST Operator" who has passed the California UST System Operator Exam administered by the International Code Council (ICC). 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 training will include, but is not limited to, the following: • 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 UST Monitoring Plan ➢ The facility employee's role with regard to spills and overfills w specified in the UST Response Plan • Names of contact persons) for emergencies and monitoring alarms. 4so.7o X. COMMENTS/ADDITIONAL INFORMATION Provide add' ' nal comments here er.indicaw how manyes with additinal info on on specific monitoring procedures are attached m di plan. 4o -7i ©v Ow—i�eJetJy30 A�C� 92,t©4- vkSvpk\ ) AcoNIS pv� (VO QNAc,tq )i. PERSONNEL RESPONSUHLITIES 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 this plan occurs, 2) all conditions that indicate a possible release are investigated, and 3) all monitoring records are maintained properly. The following on s) are res1�o ble r performing the monitoring and equipment mammitaNa NAME i \ 49 n TITLE V IGQ 49o-» NAME 49x74 TITLE 49x75 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 conditions that need follow-up action. XII. OWNER/OPERATOR SIGNATURE CERTIFICATION: I =tify,thqjhe inf9rNation provided herein is true and accttmte to the best of my knowledge. APPLICANTS 490.76 DATE: 49077 _ 12-- ZZ -o1 n / 3. Amho _ R r iv f x APPLICANT NAME (print): 490.79 APPLICANT TITLE: 49049 UPCF UST -D (12/2007) 3/4