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UNIFI7E7�D=PROGRAM CONSOLIDATED7KFORM- MONITORING PLAN (Page 2 of 2) VL UNDER DISPENSER CONTAINMENT (UDC) MONITORING 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490.54a 490.546 ® 1. CONTINUOUS ELECTRONIC MONITORING ❑ 2- FLOAT AND CHAIN ASSEMBLY ❑ 3- ELECTRONIC STAND-ALONE ❑ 4. NO DISPENSERS [199. OTHER (Specify): PANEL MANUFACTURER 4w" MODEL #: � 490-56. LEAK SENSOR MANUFACTURER:490-57 s MODEL #(S): D ^&ZI Z DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS (9 a. YES ❑ b. NO 4 59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN W a. YES ❑ b. NO 490-60. FAILURE / DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. Qg a. YES ❑ b. NO 490-61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. a. YES ❑ b. NO 490-62 2. UDC CONSTRUCTION IS ELI. SINGLE -WALLED ❑ 2. DOUBLE -WALLED 490.63 IF DOUBLE WALLED 490-64" UDC INTERSTITIAL SPACE IS MONITORED BY: 0 1. LIQUID 0 2- PRESSURE Q 3. VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑ a YES ❑ b. NO 490.64b VIL PERIODIC SYSTEM TESTING ❑ 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65. AK DETECTION D MUST BE PERFORMED. PERIODIC ELD IS PERFORM M EVERY 36 MONTHS AS CCR 2644. I 192. SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS 490 G6 19 3. SPILL BUCKETS ARE TESTED ANNUALLY. 490-67 VIM RECORDKEEPING The following monitoring/maintenance records are kept for this facility: Alarm logs 49"m RVisual Inspection Records 49o4sb j&Tank integrity testing results 49o-6Sc SIR testing results (and supporting documentation records). 49"M ❑ Tank gauging results (and supporting documentation records). 49"8e ATG Testing results (and supporting documentation records). 4go-W ❑ Corrosion Protection 60 -day logs 490-68S Equipment maintenance and calibration records. 490-M IX. TRAINING $� Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 490.69, REFERENCE DOCUMENTS MAINTAINED AT FACILITY (Check all that apply) ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN (Required) 49"% ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT (Required) 49o -69c CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49a69d CALIFORNIA UNDERGROUND STORAGE TANK LAW 49"ge STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION" 49" f ❑ SWRCB PUBLICATION: "UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 490.695 ❑ OTHER (Specify): M69h, M6% This facility has a "Designated UST Operator" who has passed the California UST System Operator Exam administered by the International Code Council (ICC). The "Designated UST Operator" will Vain 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 UST Response Plan Names of contact person(s) for emergencies and monitoring alarms. 490-70 X. COMMENTS/ADDITIONAL INFORMATION Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are aftached to this plan. 49x71 �lr �Dr XI. PERSONNEL RESPONSIBILITIES The UST Owner/Operator is responsible for ensuring that: 1) the dailyhoutine 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. possible for performing monitoring and equipment maintenance: 7s The fi 11 1 g person(s) aNAI jIJA P- A re C agar_ TITLE �! ago NAME 490.74 TITLE 490-75 T -he Designated 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. APPLI NT SIGNATURE 490-76 DATE: ago -77 7 7- REPRESENTING: 1. Tank OWf1CfI ator2 . Faality Owner/O �Yator .:\uthon�ed Re esrntative of veer 0-90-78 490-"79 APPLICANT NAME (print) - LIP 411-1 APPLICANT TITLE: Civ 1111C-lz t vA UPCF UST -D (12!2007) 3/4