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Dec 05 11 05: 21p p . 9 UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2of2) VI.UNDER DISPENSER CONTAINMENT(UDC)MONMRING 49o-sae 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING MLTROD grra,V J 4sas+b ❑ 1.CONTINUOUS ELECTRONIC MONITORING 0 2.FLOAT AND CHAIN ASSEMBLY ❑❑ 3.ELECTRONIC STAND-ALONE ❑4.NO DISPENSERS ❑99.OTHERS a9P56 PANEL MANUFACTURER: 490. MODEL.#: LEAK SENSOR MANUFACTURER: 4so-st MODEL#(S): 490.38 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUD113LE AND VISUAL ALARMS ❑ a.YES ❑b.NO '90.59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ❑ a.YES ❑b.NO 490'60. FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑b.NO a9oai UDC MONITORING STOPS THE FLAW OF PRODUCT AT THE DISPENSER ❑ a.YES ❑b.NO 4s a906s 2.UDC CONSTRUCTION IS (91.SINGLE-WALLED ❑2.DOUBLEWAI.LED ssa s 4 U DOUBLE WALLED: UDC INTERSTITIAL SPACE 1S MONITORED BY: Q L LIQUID Q 2.PRESSURE Q 3.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a YES ❑b.NO 49ad+b VII.PERIODIC SYSTEM TESTING L ELD TESTING:THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED Tie MUST BE PERFORMED. PERIODIC PLD IS PERFORMED EVERY 36 MONTHS AS UIR®. 23 CCR 2644.1 2.SEPICONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 49aaa 3.SLL BUCKETS ARE TESTED ANNUALLY. JSOd} VM.RECORDICEEPING The following monitoring/mainrcnance records are kept for this theitity: ®Alarm logs 49065+ ❑Visual Inspection Records 4sodab ❑Tank integrity testing results +zoaa ❑SIR testing results(and supporting documentation records). 49o.wd ❑ Tank gaugimg results(and supporting documentation records). 490 brae ❑ATG Testing results(and supporting documentation records).m>os5r ❑ Corrosion Protection 60-day Togs 4'J065g ❑Equipment maintenance and calibration records. nsaase IX.TRAINING ®Personnel with UST monitoring respansibilitics are familiar with all of the following documents relevant to their job duties. 49m.re+ REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all their apply) IR THIS UNDERGROUND STORAGE TANK MONITORING PLAN(gNuaM)4vossb �W OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)asorac ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS e9oas0 ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW,;o ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION",Io f ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"+sores ❑ OTHER(Specify):massa mvr 09 This facility his a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the atenatioowl Code Council(ICC). The"Designated UST Opermin"will trait facility employees in the pauper 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: D Operation of the UST systems in a manner consistent with the facility's best management practices • The facility employee's role with regard in the monitoring equipment as specified in this UST Monimring Plan D The facility employee's role with regard in spills and overfills as specified in the UST Reponse Plan • Names ofcoruact person(s)for emergencies and monitoring alarms 4wa; - X. COMMENTS/ADEIMONAL MORMATION Provide additional oommems here or andante how many pages with additional information on specific monitoring Procedures are attached to this plan.45a71 hja- atCf 14- 1/011-7-/vic e XL PERSONNEL RESPONSIBILITIES The UST Owner/Operator i5 responsible for ensuring that 1)the dailytroutine UST monitoring activities and maintenance of UST leak derection equip;m=cov by this plan occurs,2)all conditions that indicate a possible release are investigated,and 3)all monitoring records are maintained Properly. The folio all person(s),are responsible for performing the monitoring and equipment maintenance: NAME e'r S iTt 490.n TITLE - -VN C/- 4s rs NAME rn 4R}94 TITLE 4so-75 The peg Operator shall perform s monthly visual inspection of the facility, provide a report to the owner/opeream,wall return the owner/operator of any conditions 9M need follow-up action. XII.OWNEWOPERATOR SIGNATURE CERTIFICATION:I cern ry that the information provided herein is true and accurate to the best of my Cvowledge, APPLICANT SIGNAT 4soae DATE: 490,r? APPLICANT NAME(Print): j f f�wI�,U.'F1 IZ S t NGJ'14+mss AP}P.L.IC-ANT TTiE: C 479 LPCF LIST-D(12/200'O 3/4