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�..QFIED PROGRAM CONSOLIDATED FObw l UNDERGROUND STORAGE TANK MONITORING PLAN - (Page 2 of 2) (Checkall VI. UNDER DISPENSER CONTAINMENT (UDC) MONITORING tharap ly) Thar I ) UDC MONITORING IS PERFORMED USING THE FOLLOWING METHODS) ® 1.CONTINUOUS ELECTRONIC MONITORING ❑ 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 4945m. _❑_____4_.__N__O__DISP_ENSERS ❑ 99.OTHER(Specify) °90"5°x' LEAK MONITOR MANUFACTURER:Veeder-Root 49x55. MODEL#:TLS-350 49455. LEAK SENSOR MANUFACTURER:Veeder-Root 49457. MODEL#(S):794380-352 49459. DEFECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. ® a.YES ❑ b.NO 49459. ULC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑ b.NO 49 - FAILUREMISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑ b.NO 49oLt. UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. N a.YES ❑ b.NO 490-51 UDC CONSTRUCTION IS: ® 1.SINGLE WALL ❑ _2_.-D 6 U B__I WALL 49463. IF DOUBLE WALL: 40-644. UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ a.LIQUID ❑ b.PRESSURE ❑ c.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. ❑ a.YFS ❑ b.NO 494641. VII. PERIODIC SYSTEM TESTING ❑ I. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 4%65. LEAK DETECTION(FEDI MUST BE PERFORMED. PERIODIC FED IS PERFORMED EVERY 36 MONTHS AS REQUIRED.R3 CCR§'-644.❑ ® 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 49466. ® 3.SPILL BUCKETS ARE TESTED ANNUALLY. 49467. VIII. RECORD KEEPING The following monitoring/maintenance records are kept for this facility'. 49068. ® a.ALARM LOGS ❑ b.VISUAL INSPECTION RECORDS ❑ c.TANK INTEGRITY TESTING RESULTS ❑ d.SIR TESTING RESULTS(and supporting documentation records) ❑ e.TANK GAUGING RESULTS(and supporting documentation records) ® I.ATG TESTING RESULTS(and supporting documentation records) ❑ g.CORROSION PROTECTION 60-DAY LOGS ® It.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: 4%-69a. REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 49459x. ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) 49 ik. ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49459x. ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 494598. ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND 49469f. STATISTICAL INVENTORY RECONCILIATION" ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 490-69,,. ❑ OTHER(Specify): 4459h a9469i. This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council a947o. (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 person(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. 4%71 Overfill protimlion-Flapper XI. PERSONNEL RESPONSIBILITIES The UST Owner/Operator is responsible for ensuring that: l.)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)allmoni[onng records.are mamtamedproperly_ THE FOLLOWING PERSON(S)ARE RESPONSIBLE FOR PERFORMING THE MONITORING AND EQUIPMENT MAINTENANCE: NAME: Ian Moorhead 490-72. TITLE:Environmental Compliance Manager 4'"-13. NAME: Manjit & Gurpal Grewal 49 74. TITLES Franchisee 49075. The Designated UST 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 certify that the information provided herein is true and accurate to the best of my knowledge. APPLICANT SIGNATURE -7_ DATE: 490-77. REPRESEMIiNG:I]1.TaNe Owner ratty O 1 Fudity O 49476. APPLICANT NAME(print): 690-78' APPLICANT TITLE: 49x79. Ian Moorhead Env. Compliance Mgr. UPCF UST-D(12120 (7).34 www.unidocs.org