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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN—(Pace 2 of 2 VI. UNDER DISPENSER CONTAINMENT(UDC)MONITORING (Check all UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) rhwr N l�I.CONTINUOUS ELECTRONIC MONITORING ❑ 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE ❑ d.NO DISPENSERS +905+1, ❑ 99.OTHER(Specify) 490 541, LEAK MONITOR MANUFACTURER: Veeder Root 140.19. MODEL*: TLS-350R W4.F LEAK SENSOR MANUFACTURER VPPA r OO +ObjT MODEL#(Sy 794 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. 0- 08 1,w�o. UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN. a.YES-0b.Np if a.YES ❑ b.NO FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN, 9 a.YPS ❑ b.NO A0001 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. UDC CONSTRUCTION IS: 13 a,YES ❑ b.NO 4"42._.__ - - - IF DOUBL WAT 1; ¢I 1.SINGLE WALL ❑ 2.DOUBLE WALL +vont UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ a.LIQUID C3 c.VAC A LEAK WITHIN THE SECONDARY CONTAINMENTOF THE UDC TRIGGERS AUDI6❑LE AND VISUAL RALARMS. 6�e.YES UUM ❑ b.NO a9a.MM1 VII. PERIODIC SYSTEM TESTING I.ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT fNH_A�p +vans MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS RE UIRED. nccR>Earer ® 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 30 MONTHS. ® 3,SPILL BUCKETS ARE TESTED ANNUALLY. +vu.nr VIII. RECORD KEEPING The following monitoring/maintenance records me kept for this racully ® a.ALARM COGS ❑ b.VISUAL INSPECTION RECORDS j0a°" ❑ d.SIR TESTING RESULTS ands ❑ c.TANK INTEGRITY TESTING RESULTS ( u PPOrli g documentation records) ❑ e.TANK GAUGING RESULTS(and supporting documentation records) ❑ It ATG TESTING RESULTS(and wp AND documentation records) ❑ g.CORROSION PROTECTION GU-DAY LOGS h.EQUIPMENT MAINTENANCE AND CALIBRATION RECORDS IX. TRAINING Personnel with UST monjtoring tesponsibilides are familiar with all of the following dasuments relevant to their job duties: REFERENCE DOCUMENTS MAINTAINED AT FACILITY/Check off that altplvJ +xWN+ ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) jV0{9a' ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS +wavc ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW +Wray ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND a�r. STATISTICAL INVENTORY RECONCILIATION" ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" ❑ OTHER(Specify)- This hciliry bass"DesilpwZ��b perator"who Iles posed the California UST System Operator Exam administered by the International Cade Council (ILLI. The 'Designated Utar"will train facility employees in the proper operalion and maintenance of the UST sth ems annually,and within 30 days o(hire.This training wput is not limited to,the following: Operation of the UST symanner coma at with the facifiry's beat mans ementThe futility employee's regard m the monitalin p g practices. The Estill �, 1.eyuipmP tazs etfied in this UST Monitoring Plan. ry employee's rgard to ills end oveMlls es s ccified in die facility's USi Rraporue plan. Namefs)of contact persoergencies and monitoring alarms. X. COMMENTS/ADDITIONAL INFORMATION Provide additional comments here or indicate law many pages with additional inlamution on specific monitoring procedures aro attached to this plan. Overfill prevention equipment for each UST probe:external audio/visual alarm set at 90%tank capacity, XL PERSONNEL RESPONSIBILITIES The UST Chsner/Operator is raponsibla far insuring BrN; L)the dailyAounna UST mMitodng sauvides end mainteruntt of UST leak detection equipment covered by this plan scuts;2.1 ell corditbns that indieare a passible release arc investignsod;and J)NI monitoring records ere maintained properly, THG FOLLO W[NG PERSONS)ARE RESPONSIBLE FOR PERFORMING THE MONITORING AND EQUIPMENT MAINTENANCE; NASIE: Dennis BOCk +00-'/'. TITLE: NaMc: Tim rlock , �+ Environmental Compliance Manor er 1973 TmE: Dir for f soli *7t The Designated UST Operator she))perform a momhl visual im araC ions 4W conditions that need follow.0 action. y peclioe of Ne Yaciliry,providn s repots m rile owtrer/oppator and infarmO the owner/o pemlar of any XII. OWNER/OPERATOR SIGNATURE CERTIFICATION:1 eerti that The information rovided heti n Is true and accurate tothe best of m knowled e. APPLICANT SIGNATURE DATE: +was. REPRESENTIFG: LT�aAnerq rxr E.Adla ooxW.ro tAunwvidRevcunua.xorllnwv +4arfi June 14, 2010 APPLICANT NAVE(print): Dennis $OCk +v1,-7x.I APPLICANT TITLE ax04x. Environmental Compliance Manager PPCF L'ST•D(12/2007)-3/4 www.anidaccora