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UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN-(Page 2 of 3 <br /> VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING (chectau <br /> char <br /> UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) <br /> ® I.CONTINUOUS ELECTRONIC MONITORING ❑ 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 490-54.. <br /> ❑ 4.NO DISPENSERS__ ❑ 99,OTHER(Specify) 490-54b. <br /> LEAK MONITOR MANUFACTURER:Veedel'Root 490-55. MODEL#:TLS-35OR 490-56. <br /> LEAK SENSOR MANUFACTURER:Veeder Root 490-57. MODEL#(S):794380-323 490.59. <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. ® a.YES ❑ b.NO 490-59. <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑ b.NO 490-60. <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑ b.NO 490.61. <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ® a.YES ❑ b.NO 490-62. <br /> UDC CONSTRUCTION IS ® I.SINGLE WALL ❑ 2.DOUBLE WALL 490.63, <br /> IF DOUBLE WALL: 490-64e. <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 ❑ b.NO 490-64b. <br /> VII. PERIODIC SYSTEM TESTING <br /> I.ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65- <br /> LEAK DE1TQnQNffjW <br /> MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED.123 CCR§2644.11 <br /> ® 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490-W <br /> ® 3.SPILL BUCKETS ARE TESTED ANNUALLY. 490-67 <br /> 19-1 VIII. RECORD'KEEPING <br /> The following monitoring/maintenance records are kept for this facility: 4907 <br /> ® a.ALARM LOGS ❑ b.VISUAL INSPECTION RECORDS ❑ c.TANK INTEGRITY TESTING RESULTS <br /> ❑ d.SIR TESTING RESULTS(and supporting documentation records) ❑ e.TANK GAUGING RESULTS(and supporting documentation records) <br /> ❑ f.ATG TESTING RESULTS(and supporting documentation records) ❑ g.CORROSION PROTECTION 60-DAY LOGS <br /> ® h.EQUIPMENT MAINTENANCE AND CALIBRATION RECORDS <br /> IX. TRAINING <br /> Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties: 490-69. <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) <br /> ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 490-69b. <br /> ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)* 490.69c. <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d. <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-6%k <br /> ❑ 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" 490.698. <br /> ❑ OTHER(Specify): 490-69h. <br /> 490-69L <br /> This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam 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 monitoring procedures are attached to this plan. 49041. <br /> *Monitoring systems manual maintained by contracted,licensed pump and tank technicians. <br /> Best Management Practices are maintained in the H.S.S.E.Retail Facility Programs Manual(Green Binder). <br /> `Tank Overfill Protection Type: Overfll alarm and ball float visual and audible alarm at tank fill point(s)and operates alarms trigger at 90%. <br /> XI. PERSONNEL RESPONSIBILITIES " <br /> The UST Owner/Operator is responsible for ensuring that: 1.)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment covered <br /> by this plan occurs;2.)all conditions that indicate a possible release are investigated;and 3.)all monitoring records are maintained properly. _ <br /> THE FOLLOWING PERSON(S)ARE RESPONSIBLE FOR PERFORMING THE MONITORING AND EQUIPMENT MAINTENANCE: <br /> NAME: STEVE COMLEY 490-72. TITLE:HSSE MANAGER 490-73. <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 any <br /> conditions that need follow-up action. <br /> XII. OWNER/OPERATOR SIGNATURE <br /> CERTIFICATION:I certify that the information provided herein Is true and accurate to the best of my knowledge. <br /> APPLICANT SIGNATUREN DATE: 490-77. <br /> AN <br /> REPRESENTING:❑I.Tuck 0.mr/ 0 2.Faeilrt O / s r®l.Authorized Rcprwntzlne of 0- 490-76. <br /> APPLICANT NAME(print): 090-78. APPLICANT TITLE: 490-79. <br /> JLQNIFER M. MARINAS Environmental Compliance Specialist <br /> Arco 02186,Belsh§re Environmental Services Page 2 of 6 <br />