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• <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN - (Page 2 of 2) <br /> VI. UNDER DISPENSER CONTAINMENT (UDC) MONITORING (Check au <br /> that apply) <br /> UDC MONITORING IS PERFORMED USING THE FOLLOWING METIIOD(S) <br /> E 1.CONTINUOUS ELECTRONIC MONITORING ❑ 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 490-54a. <br /> ❑ 4.NO DISPENSERS ❑ HE (Specify)99.OTR S ecif 490-54b. <br /> _____..........._________----__........__.._----.....___........................_ <br /> LEAK MONITOR MANUFACTURER:Veeder Root 490-55. MODEL#:TLS-350 490-56- <br /> LEAK SENSOR MANUFACTURER:Veeder Root 490-57. MODEL#(S):794380-323 490-58. <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. E a.YES ❑ b.NO 090-59. <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN. E a.YES ❑ b.NO 490-60. <br /> FAILUREIDISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. E a.YES ❑ It.NO 490-61. <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. _ E a.YES ❑ b.NO 490-62, <br /> UDC CONSTRUCTION IS: <br /> E 1.SINGLE WALL -_____Q-2 DOUBLE WALL v-- -- °90'63 <br /> IF DOUBLE WALL: 49a64. <br /> UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ a.LIQUID ❑ b.PRESSURE ❑ c.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. ❑ a.YES E b.NO 490-646. <br /> VII. PERIODIC SYSTEM TESTING <br /> ❑ 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65. <br /> LEAK DETECTION ELD MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED.I23 CCR g2644.1 <br /> E 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490-66_ <br /> E 3. SPILL BUCKETS ARE TESTED ANNUALLY, 490-67 <br /> VIII. RECORD KEEPING <br /> The following monitoring/maintenance records are kept for this facility: 490-68. <br /> E a.ALARM LOGS ❑ b.VISUAL INSPECTION RECORDS E c.TANK INTEGRITY TESTING RESULTS <br /> ❑ d.SIR TESTING RESULTS(and supporting documentation records) ❑ e.TANK GAUGING RESULTS(and supporting documentation records) <br /> ❑ E ATG TESTING RESULTS(and supporting documentation records) ❑ g.CORROSION PROTECTION 60-DAY LOGS <br /> E h.EQUIPMENT MAINTENANCE AND CALIBRATION RECORDS <br /> IX. TRAINING <br /> E Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to theirjob duties: 490-69a. <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) <br /> E THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 490-69b. <br /> E OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) 490-69c. <br /> E CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d. <br /> E CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-6%. <br /> E STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND 490-69f <br /> STATISTICAL INVENTORY RECONCILIATION" <br /> ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 490'69, <br /> E] OTHER(Specify): 490-696. <br /> 490-69i. <br /> E This facility has a"Designated UST Operator"who has passed the California UST System Operator Elam administered by the International Code Council 490-70. <br /> (ICC). The "Designated UST Operator"will train facility employees in the proper operation and maintenance of the UST systems annually,and within 30 <br /> days of hire.This training will include,but is not limited to,the following: <br /> ➢ Operation of the UST systems in a manner consistent with the facility's best management practices. <br /> ➢ The facility employee's role with regard to the monitoring equipment as specified in this UST Monitoring Plan. <br /> ➢ The facility employee's role with regard to spills and overfills as specified in the facility's UST Response Plan. <br /> ➢ Name(s)of contact person(s)for emergencies and monitoring alarms. <br /> X. COMMENTS/ADDITIONAL INFORMATION <br /> Provide additional comments here or indicate how many pages with additional information on specific orooting procedures are attached to this plan. 490-71. <br /> O t <br /> XI. PERSONNEL RESPONSIBILITIES <br /> The UST Owner/Operator is responsible for ensuring that I.)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment covered <br /> _by this,plan-occurs_21 all conditions that indicate a possible release,are inveshpzated:and 3.)all monitorinpzrecords are mamtainedproperly. _ <br /> .... __.. .............. <br /> THE FOLLOWING PERSON(S)ARE RESPONSIBLE FOR PERFORMING THE MONITORING AND EQUIPMENT MAINTENANCE: <br /> NAME: Lai Jojinder 490-72 TITLE:Operator/OWOer 490-73. <br /> NAME: 49a74. TITLE: 490-75. <br /> 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-an y <br /> conditions that need follow-up action. <br /> XII. OWNER/OPERATOR SIGNATURE <br /> CERTIFICATION: 1 certify that the information provided herein is true and accurate to the best of my knowledge. <br /> APPLICANT SIGNA_T_U�E DATE: 45o-77. <br /> rr o t "�C-� Ls/2o/Zoos <br /> REPRESEM NG:®I.Tank Owner/ ator 2.Facilit Owner/0 raror❑ .Amhorimd Re reeentative of Owner 490-76. <br /> APPLICANT NAME(print): 490-78. APPLICANTTITLE: 690-79' <br /> Lal Joinder Operator/Owner <br /> UPCF UST-D(12/2007)-2/3 www.unidocs.org <br />