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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN —(Page 2 of 2 VI. UNDER DISPENSER CONTAINMENT(UDQ MONITORING -a hat rMCONTINUOUS ORING IS PERFORMED USING THE FOLLOWING METHODS) ELECTRONIC MONITORING X 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONICSTAND-ALONESPENSE IS ❑ 99.OTHER S— _ _ ___. _ _-.__ ( pecify) a90.14b AK MONITOR MANUFACTURER: a9oss MODELM: e96-<a AK SENSOR MANUFACTURER: 4�17 MODEL N(S): sa-ss DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. ❑ a.YES X b.NO d90'a9 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN, a YES X b.NO 4". FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES X b.NO 48661 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. _ __ X a VES ❑ b.NO 490'62 UDC CONSTRUCTION IS: X I.SINGLE WALL ❑ 2.DOUBLE WALL °00-61 IF WLByp WAt 1: go W. UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ a LIQUID ❑ It PRESSURE ❑ C.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF I HE UDC-IRIGGERS AUDIBLE AND VISUAL ALARMS. ❑ a YES ❑ b.NO 49 1, VII. PERIODIC SYSTEM TESTING I.ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT FNHANCFp 49obs MUST BE PERFORMED. PERIODIC L'LD IS PERFORMED EVERY 36 MONTHS AS REQUIRED.m GGR ® 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 4W 66 ® 3.SPILL BUCKETS ARF.TESTED ANNUALLY. a9a.6r VIII. RECORD KEEPING The following monitoring/maintenance records are kept fm this facility: a9a6e ® a ALARM LOGS ❑ b.VISUAL INSPECTION RECORDS ❑ c.TANK INTEGRITY TESTING RESULTS j ❑ d-SIR TESTING RESULTS(and supporting documentation records) ❑ C.TANK GAUGING RESULTS(and supporting documentation records) ❑ L ATG TESTING RESULTS(and supporting documentation records) ❑ g.CORROSION PROTECTION 60-DAY LOGS ® h.E UIPMENT MAINTENANCE AND'A'—RATION RECORDS IX. TRAINING Personnel with UST monitoring responsibilities are familiar with all ofthe following documents relevant to their job duties: a9o.69. REFERENCE DOCUMENTS MAINTAINED.AT FACILITY(Check all that app(v) ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 4y ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) 49aa99 ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49 4 ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 49a69a ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND 490.69!' STATISTICAL INVENTORY RECONCILIATION" ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 49 sa ❑ OTHER(Specify). 9069n 9Ud9i This facilityhas a"Designated UST Operator"who has passed the California UST System Operator Exem administered by the In[emmional Code Council s9a.ro ' (ICC). The "Designated UST Operator"will train facility employees in the proper operation and maintenance of the UST syswms annually,and within 30 days of hire.This training will include•but is not limited to,the fallowing: 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 rate with regard to spills and overfills as specified in the facility's UST Response Plan. > Name(s)of contact persons)for emergencies and monitoring alombs. 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�t1 XI. PERSONNEL RESPONSIBILITIES The UST Owner/Operator is responsible for ensuring that: 1.)the daily/routine UST monitoring activities and maintenance of UST leak detectio;equilancil covered lan occurs;2_)all conditions that_nd cate a possiblerelease are invested;and 3.)alI maniratingrecords are maintained Droperly.THE FOLLOWING PERSON(S)ARE RESPONSIBLE FOR PERFORMING THE MONITORING AND EQUIPMENT MAINTENANCE:NAME: Guillermo Lopez 490.12. TITLE.ManagerNAME: Sandy Edwards i90-1JTITLE:Environmental Compliance Admin. A9075 The Designated UST Operator shall perform a monthly visual inspection of the facility,provide a report to the owner/operator,and inform the operamr of any conditions that need follow-up action. XII, OWNER/OPERATOR SIGNATURE CERTIFICATION: 1 certify that the information provided herein is true and accurate to the best of my knowled e. APPLICANT SIGNATURkt�) r I DATE: a9o-n \\ ' LC�-� 6/8/09 RF3RESEY, NG Xi TaNO ,, rut 2.Faile Own iar J AutMrimd imw ofOwnv a90.r6. UPCF UST-D(122007)-418 www.unldocs.org