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04/17/2008 20:05 5107963470 SHARMA PAGE 03 t Qqc 3 dooS UNIFIED PROGRAM CONSOL VATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN - (Page 2 of Z V1. UNDER DISPENSER CONTAINMENT (UDC) MONITORING (Check all that ! UDC MONITORING IS PERFOWMED USING THE FOLLOWING METH01)(5) ❑ 1.CONTINUOUS ELECTRONIC MONITORING ❑ 2.FLOAT AND CHAIN ASSEMRL Y ❑ 3.ELECTRONIC STAND-ALONE 490-54& ❑ 4.NO DISPENSERS ❑ 99.OTHER(Specify) 49a54b. LEAKMONIT0RMANt7FACT(JRER: VeeVe —000-T a9oas. MODEL#: TI-.S-35-0 a9ass j LEAP:SENSORMANUFACTIIRER: 'f,/eE me— �-[�ooT t�s� MODEL#(5): -T q �lbo•- 3 t�Ss 6f DETECTION OF A LEAK INTO TIS UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. s.YES © b.NO 410-- I UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN. $a,YES ❑ b.NO 490.40' I FAILUREJUTSCONNECTION OF UTC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. a.YES ❑ b.NO 490-6t. UDC MONITORING STOPS THE FLOW OF PRODUCT AT TITS DISPENSER. Ig a.YES Q b.NO 4946., UDC CONSTRUCTION IS: ❑ 1.SINGLE WAIL ❑ 2.DOUBLE WALL ago es, j jri�j,�.WALL: aoo 54e. UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ a.LIQUID ❑ b.PRESSURE [I c.VACITIRV A LEAK WITHIN T14Y SECONDARY CONTAINMENT OF TIIE UAC TRIGGERS AUDIBLE AND VISUAL ALARMS. [] a.YES [] b.NO 490,.64b. VII. PERIODIC SYSTEM TESTING 1.ELD TESTING' TMS FACILITY 14AS BEEN NOTITIE.D 13Y THE,STATE WATER RESOURCES CONTROL BOARD TRAT ENUANCEO 490-65. MUST BE PERFORMED. PERIODIC ELD IS P5RFORMF,D EVERY 36 MONTHS AS REQUIRED.rzs CCR J2644.[ ® a,SECONDARY CONCAINMEN I COM1'ONJ:XFS AgE JESTED EVERY 36 MONTHS. 49°•66. ® 3. SPILL BUCKFTS ARE TESTED ANNUALLY. 490-67, VIII. RECORD KEEPING The following monitoring tnaintenance records are kept for this facility: 490-68. n,ALARM LOGS ❑ b.VISUAL TNSPECTTON RECORDS ❑ c.TANK INTEGRITY TESTING RESULTS ❑ d.SIR TESTING RESULTS(and supporting documentation records) ❑ e.TANTO G.AUGTNG RESULTS(and supporting documentation rmords) ❑ f.ATG TESTING RESULTS(and supporting documentation records) ❑ ff CORROSION PROTECTION 60-DAY LUGS ® h.EQUIPMENT MAINTENANCE AND CALIBRATION RECORDS _ IX. TRAINING I'cr Kmncl with UST monitoring responsibilities are familiar with alt of the fallowing documents relevant to their job duties: 490-69►. REFERENCE DOCUMEIVTS.MA.INTALNED AT FACILITY(Checkall that apph) ® f WS UiNDERCiROUIN'D STORAGE TANK MONITORING PLAN(Required) Oso-Fiat, ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUlPNIEN'T(Required) 490-69c. © CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490.69d. ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 490.694. ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND 49o-69L STATISTICAL.TNVFNTORY RECONCILIATION" ❑ SWRCB PUBLICATION:"UNDERSTANDD G AUTOMATIC TANK GAUGING SYSTafs" 490-6ft ❑ OTHER(Specify): 490-6M, 49J-69r, This facility has a"Designated TiST Operator"who has passed the California UST System Operator ExAm administered by the International Code Council 4QOY'70 (ICC). The "Designated UST Operator"will train facility employees in the proper operation and maintenance of rhe UST systems annually,and within 30 duy%of hire.This training v411 include,but is not limited to,the following; > Operation of the UST systems in a marmer consistent with the facility's best management practices. > The facility employee's role with rrgnrd W the monitoring Nuipment as specified in this UST Monitoring Flari. D The facility employee's role with regard to spills and overfills as specified in the facility's UST Response Flan. > Name(s)of contact person(.-,)for emergencies and monitoring alarms. i X. COMMENTS/ADDITIONAL INFORMATION Provide additional comments here or indicate how an pages with additional information on eci4ic,�7 itapm a he to is I age't. • {W1Ofv�ATlt. Pun1P S VT aFF WIIeN l R `CkSE is 52a,t<D tN .BtN k;39 ,Wl". ENyCUrAftR,ta:C frit It CtD�IroG S �C�Fhi�S !I XI. PERSONNEL RESPONSIB ITIES The UST Owner/Operator is responsible for ensuring that: 1.)the daiEy/routine UST monitoring activities and maintenance of UST lc4k detection equipment oovered by this PlarT occurs:2_)all conditions,that indicate apossxble release are investigated;and monitorm records are rnatntatned properly._„__ -_-- - - _— TIIE FOLLOWING PERSON(S).ARE RESPONSIBLE FOR PERFORNIING THE MONITORTNC}AND EgUIPMENT MAINTENANCE: NAME: --i iL Ck kDo x 490-722. TTFLE: McMe'E'(1— 49o_73. NAME: —EP skwmpr 49474. TITLE: M F_ C A- 490-75. The Designated UST Operator shall perform a monthly visual.inspection of the facility,provide a report to the owner/operator,and infotnr the owner/operator of anv conditions that need foliow-u action. XII. OWNER/OPERATOR SIGNATURE CERTIFICATION.,I certify that the information provided herein i5 true and accurate to the best of my IsuowkdRe. APPLICANT SIGNATURE DATE: - 4v0 7. MMESEN .`G:❑t,tank Owner or 2.Pahl. O+ma/O ecator 3..1ut};dr aeentnive of Oona 49'}7G. APPLICANT NAME(print): APPLICANT TITLE: 490 V U LDE E P C - SN X1+1"rt,ea.1 c Fo UPCF UST-D(12/2007)-3/4 v ww.unidoc&org