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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN—(Page 2 of 2 VI. UNDER DISPENSER CONTAINMENT(UDC)MONITORING (Check all UDC MONITORING IS PERFORMED USING THE FOLLOWING MF,THOD(S) that a Lq L CONTINUOUS ELECTRONIC MONITORING ❑ 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 4g 54.. ❑ 4.NO DISPENSERS_ ❑ 99.OTHER(Specify) 4W54b. LEAK MONITOR MANUFACTURER Veeder Root 49167MODEL#: TLS-35OR 49_SK._ LEAK SENSOR MANUFACTURER: Ve d Rao 49.57. MODEL#(S): 794380-208 49058. DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. 9 a.YES ❑ b.NO 4se-59. UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN. r6 a.YES El b.NO 490-60.FAILURE/DISCONNECT[ON OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. gr a.YES ❑ b.NO 490.61. UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. _ YES ❑ b.NO 49ou UDC CONSTRUCTION IS: 1.SINGLE WALL El 2.DOUBLE WALL 490.63. IF DOUBLE WALL UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ a.LIQUID ❑ b.PRESSURE4906 ❑ c.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THEUDC TRIGGERS AUDIBLE AND VISUAL ALARMS. Sira.YES ❑ b.NO 690'6°6. VII, PERIQDIf SYSTEM TESTING I.PLO TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 49065. !E-DETECTION(ON(ELD)MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS RE UIRED.[23 CCR 32644.1] Rg 2.SECONDARY CONTAINMENT COMPONENTS ARF4 TESTED EVERY 36 MONTHS. 49P66. ® 3.SPILL BUCKETS ARE TESTED ANNUALLY. 49067 VUL RECORD KEEPING The following monitoring/maintenance records are kept for this facility: 4% 8 ® a.ALARM LOGS ❑ b.VISUAL INSPECTION RECORDS ❑ c TANK INTEGRITY TESTING RESULTS ❑ d.SIR TESTING RESULTS(and supporting documentation recerds) ❑ e.TANK GAUGING RESULTS(and supporting documentation records) ❑ f.ATG TESTING RESULTS(and supporting documentation records) ❑ g.CORROSION PROTECTION 60-DAY LOGS h.EQUIPMENT MAINTENANCE AND CALIBRATION RECORDS IX. TRAINING Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties: 49ae9a. REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 49069& ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) 49 % ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49o.69e ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 49as9< ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND 490-Of. STATISTICAL INVENTORY RECONCILIATION' ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 4W601. ❑ OTHER(Specify): 490-690. 490.691. This facility has a"Designated UST Operator'who has passed the California UST System Operator Exam administered by the International Code Council 4 (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 as specified in the facility's UST Response Plan. > Name(s)of contact pemon(s)for emergencies and monitoring alarms. X. COMMENTS/ADDITIONAL INFORMATION Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan. 490-7. XL PERSONNEL RESPONSIBILITIES 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_)alI conditions that indicate a possible release are investigated_and 3. all monimrina records are maintained property._____ THE FOLLOWING PERSON(S)ARE RESPONSIBLE FOR PERFORMING THE MONITORING AND EQUIPMENT MAINTENANCE: NAME: Dennis Bock 49an TITLE: Environmental Compliance Manager 490-73. NAME: Tim Hurlocker 490']° TITLE: Director Of Gas0l lne operations 405' The Designated UST Operator shall per conditions that need follow-up action. form a monthly visual inspection of the facility,provide a report to the owner/operator,and inform the owner/operator of any XIL OWNER/OPERATOR SIGNATURE CERTIFICATION:I certify that the information provided herein is true and accurate to the best of m knowledge. APPLICANT SIGNATURE DATE:� 49on.ub `z�z � l 2p1� REPRESENTmG:D LTmx Owrc nlbr 2.FeNi Owner/0 wr0).Amlroriud ..'w'ofnwnx 490.76. APPLICANT NAME(print): Dennis Bock 490.78. APPLICANT TCCLE: 490-]9. Environmental Compliance Manager UPCF UST-D(12/2007)-314 3vww.unldocs.org