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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUNDSTORAGETANK MONITORINGPLAN (Page2ot2) VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING I. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490 490546ZO ❑ 1.CONTINUOUS ELECTRONIC MONITORING 112.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 19 4 NO DISPENSERS 1199,OTHER(Specify): _ PANEL MANUFACTURER: 490'ss MODEL#: 4voss. LEAK SENSOR MANUFACTURER: 79075i- MODEL#(S): 49a59 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑ s.YES ❑b.NO 490.99 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ❑ a.YES ❑b.NO 49061k FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑b.NO 49061 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER ❑ a.YES ❑b.NO 49062 2.UIIC CONSTRUCTION LS 111.SINGLE-WALLED 112.DOUBLILWALLED 4906r IF DOUBLE WALLED: 4906°' UDC INTERSTITIAL SPACE IS MONITORED BY: 1.LIQUID ❑2.PRESSURE 3.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑c YES ❑b.NO 4909 b VII.PERIODIC SYSTEM TESTING 1. ELD TESTING:THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 4s MUST BE PERFORMED. PERIODIC ELD IS PERFORMBD EVERY 36 MONTHS AS REQUIRED.(23 CCR§2644.x___ 9 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. -- f ®3.SPILL BUCKETS ARE TESTEDANNUALLY. 49069 ! VIII.RECORDKEEPING The following monitoring/maintenance records are keptfor this facility: ®Alarm logs 490489 N Visual Inspection Records 490-69b ❑Tank integrity testing results 490as9 ❑SIR testing results(and supporting documentation records). 49668d ❑ Tank gauging results(and supporting documentation records). 4909 ❑ATG Tesfing results(and supporting documentation records).4s0aar ❑ Corrosion Pramcdon 60-day logs 49°.6x8 ❑Equipment maintenance and calibration records. 49oaah j IX.TRAINING ®Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant t0 theirjob duties. 49°x9, REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490-6% N OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)4soasc N CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS Oma% ® CALIFORNIA UNDERGROUND STORAGE TANK LAW 490x9. ® STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"Oso of N SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490699 ❑ OTHER(Specify):M69K W% This facilityhas a"Designated UST Opemlot"who has passed the California UST System Operator Earn administered by the International Cade Council(ICC). The`Designated UST Operator"will train facility employees in the proper operation and maintenance of the UST systems mums dly,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 miner 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 D The facility employee's role with regard to spills and overfills as specified in the UST Response Plan ➢ Names ofconact personas)for emergencies and monitoring alarms.49 lir X. COMMENTS/ADDITIONAL INFORMATION - Provide additional comments hero or indicate how many pages with additional information on specific monitoring proceduros are attached to this plan.49 v - OVERFILL KK4;"ON -t- E IfAN(CA L FL�PME AT C15°/0 XI.PERSONNEL RESPONSIBILITIES The UST Owner/Opemar 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. The followin person(s)am responsible forperforming the monitoring and equipment mailitenan0c NAME'T c 1r d% 49arz TITLE r7E123/I p, -VAC }t c I N Oto-rr NAME 490-74 TITLE K0Ca1QWAL C. +- 490-7 The Designated Operator shall perform a monthly visual inspection of the facility,provide a report to the owner/operator,and atom,the owner/operator of any conditions that need follow-up action. XIL OWNER/OPERATOR SIGNATURE CERTDTLCATION:I certify that the information provided herein is true and accrrate to the but of my knowled m APPLICANT SIG N/�/ URB�j/ /� 490-)6 DATE: 490-77 APPLICANT NAME(print): 49099 APPLICANTTTTLE: 490-,9 GOR-414 SLt,9�Ez S�G�7Y GsAp�12 UPCF UST-D(122007)3/4 '