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001200 UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN— a e 2 of 2 VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING damhtak l° UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) 1.CONTINUOUS ELECTRONIC MONITORING ❑ 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 490154& ❑ 4.NO DISPENSERS _ ❑ 99.OTHER(Specify) 49asm LEAK MONITOR MANUFACTURER90/7 f 490-99. MODELd: ' v 490-96. LEAK SENSOR MANUFACTURER: E: P„ L.�1 T asr. MODEL M(Sy. 4vo-sa DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. (Q a.YES ❑ b.NO 490.59' UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN. f& SS ❑ b.NO490'60FAR.URF/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. [Ib.NO 490-6tUDC MONITORING STOPS THE FLAW OF PRODUCT AT THE DISPENSER. YES ❑ b.NO UDC CONSTRUCTION IS: 1.SINGLE WALL ❑ 2.DOUBLE WALL 490-69. IF DOUBLE WALL. 49-664& 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 YES ❑ b.NO 490-ws. VII. PERIODIC SYSTEM TESTING 1.ELD TESTING:THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65. LEAK DMCMN CELDIMUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED.Isr cciijs .t ® 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. L _?! nvV` 490-66 ® 490.67 3.SPILL BUCKETS ARE TESTED ANNUALLY. VIII. RECORD KEEPING The following monitoring/maintenance records are kept for this facility: 49a6R ® 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) ❑ f ATG TESTING RESULTS(end supporting documentation records) ❑ g.CORROSION PROTECTION 60-DAY LOGS • h.EQUIPMENT MAINTENANCE AND CALIBRATION RECORDS DL TRAINING • Personnel with UST monitoring responsibilities are familiar with all of the folk wing documents relevant to their job duties: 490-69& REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) ®THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 490699. ®OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) < 69& ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49a69d. ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 49069-6 ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS MANUAL AND 490-697 STATISTICAL INVENTORY RECONCILIATION" 4906$ ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 490-69-6. ❑ OTHER(Specify): 490-6a. This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council 490-70 (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 mining 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 to the monitoring equipment as specified to this UST Monitoring Plan. D The facility employee's role with regard to spills and overriEs as specified in the facility's UST Response Plan. > Name(s)of concoct persons)for emergencies and monitoring alarms. X. COMMEN'T'S/ADDITIONAL INFORMATION Provide additional comments�e or indicate taw many pageSW With additional information on specific monitoring procedures am attached to this plan. 490.91 ^O XI. HEIRSCINNELRESPONSEDIDLITIE6 The UST Owner/Operator is responsible for ensuring that:1.)the daily/routme UST monitoring activities and maintenance of UST leak demotion equipment covered Nis plan occurs:2.)all conditions that indicam a possible release ere investigated:aM 3J all monimring recoMs are mainrairred properly. _ TIES FOLLOWING PERSON(S)ARE RESPONSIBLE FOR PERFORMING THE MONITORING AND QUIFMENT MAINTENANCE: NAME: 4907-6. TITLE: �l 49x73. ' / NAME: t 490-74 TITLE: 490-75. The Designated UST Opemmr 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 accumte to the bat of my Imowkd e. APPLICANT SIGNATURE E. DATE: J/.7 49an. REPRESrIN6 I.TSRom,era ectal O,m ).AwaorimlRe rammire otOwna 490. y. 76. ! t, - O'A/ '� Oq APPLICANT NAME(print): '190.78' APPLI ANTTITLE: 490.79. UPCF USI'-D(12/2007) 3/4 www.unideesarg