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IFIED PROGRAM CONSOLIDATED FORNW UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VI. UNDER DISPENSER CONTAINMENT(UDC)MONITORING 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-54. ❑ I.CONTINUOUS ELECTRONIC MONITORING Pd 2.FLOAT AND CHAIN ASSEMBLY 490-54b ❑ 4.NO DISPENSERS ❑ 3.ELECTRONIC STAND-ALONE _________—__________099.OTHER(Specify)_____—___ — ___ _ PANEL MANUFACTURER: � — _------ 0.90.-65 ------- ----'------- ___—__ �� J�/L�14,C 490-s6. LEAK SENSOR MANUFACTURER: r 0.90-57 ----S): .r__--------- o-CIt14 .N MODEL#((S): 490-58 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS 0 a YES ❑b.NO 491-19 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 490'61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ❑ a YES ❑b.NO 490.62 2.UDC CONSTRUCTION IS R.SINGLE-WALLED [12.DOUBLE-WALLED 490-63 IF DOUBLE WALLED: --49064e---- UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ I.LIQUID—❑2.PRESSURE _❑3.VACUUM ____ A LEAK WITHIN THE SECONDARY CONENTTAMMOF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b NO --- 490-646 VII.PERIODIC SYSTEM TESTING ElI. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 0.90.6-6. LEAK DETECTION(ELD)MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS R_EQUIRED_S23 CCR 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490.66 3.SPILL Bl1CKET5 ARE TESTED ANNUALLY. -------------"-------"------------------------------------ 490-61 VHI. RECORDKEEPING The following monitoring/maintenance records are kept for this facility: ER Alarm logs 490-68a [A Visual Inspection Records 490-68b El Tank integrity testing results 490-68c E]SIR testing results(and supporting documentation records). 49a6ad ❑ Tank gauging results(and supporting documentation records). 490-6ae El ATG Testing results(and supporting documentation records).49MEn' El Corrosion Protection 60-day logs 490-688 ❑Equipment maintenance and calibration records. 490-68h IX.TRAINING JR Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to theirjob duties. 491-690. REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) © THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490-69b ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490-6k E?J CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49049d &CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-6% ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"490-697 ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490.698 ❑ OTHER(Specify):m69q m69i 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[rain facility employees in the proper operation and maintenance of[he UST systems annually,and within 30 days of hire.This Vaining will include,but isnot limited[q[he following: ➢ Operation of[he UST systems in a manner consistent with the facility's best management practices ➢ The facility employee's role with regard[o lite monitoring equipment as specified in[his UST Monitoring Plan ➢ The facility employee's role with regard to spills and overfills as specified in the UST Response Plan ➢ Names of contact persons)for emergencies and monitoring alarms.490-10 X. COMMENTS/ADDITIONAL INFORMATION Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plat 490-71 0VFn-F1L�L_ PaEi./EtiTiaN is 5Cf Itr qf% CV1?A'n1 gj InF046A.'1(4-U Fu9f XI.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)all conditions that indicate a possible release are investigated,and 3)all monitoring records are maintained properly. Th»�Elowin person(s)`are responsible for performing the monitoring and equipment main[ nanc 490-r2 TITLE ,Q )pF�l 4�r3 NAME Z S 490-74 TITLE r} L n The Designated Operator shall perform a monthly visual inspection of the facility, provide a report to the owner/operator, and inform the owner/operator conditions that need follow-up action. XII. OWNER/OPERATOR SIGNATURE CERTIFICATION: I certify that the information provided herein is true and accurate to the best of my knowledge. APP IGNATURE 490-76 DATE: �_a9aI1 �T.k Prazor 2.F 'lit wn r/O eralor 3.Au horized R r ntativ towner O. APPLICANT NAME(print): 490-78 APPLICANT TITLE: r�;a0o-79 MAT UPCF UST-D(12/2007)3/4