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7iIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORINGPLAN (Page2of2) <br /> VL UNDER DISPENSER CONTAINMENT([IDC)MONITORING <br /> 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD <br /> 490.546 <br /> X 1.CONTINUOUS ELECTRONIC MONITORING ❑ 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE <br /> ❑ 4.NO DISPENSERS ❑99.OTHER(Specify): <br /> PANEL MANUFACTURER Veeder Root TLS 350-R °90"55 MODEL* 848290-012 490-56. <br /> LEAK SENSOR MANUFACTURER Veeder Root 411 1 MODEL#(S): 794380-208 49038 <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 49060. <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 /> 2.UDC CONSTRUCTION IS X 1.SINGLE-WALLED D 2.DOUBLE-WALLED °" <br /> IF DOUBLE WALLED: 490 <br /> UDC INTERSTITIAL SPACE IS MONITORED BY: ❑1.LIQUID ❑2.PRESSURE ❑3.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ®a.YES ❑b.NO 490.646 <br /> VELPERIODIC SYSTEM TESTING <br /> 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65- <br /> LEAK _ LD MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED. 23 CCR 2644.1 <br /> ®2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 49°66 <br /> 3.SPELL BUCKETS ARE TESTED ANNUALLY. 49W <br /> VIII.RECORDKEEPING <br /> The following mcnitoring/maintenance records are kept for this facility: <br /> ®Alarm logs 4906sa ❑Visual Inspection Records 490-686 ❑Tank integrity testing results 490-6sc <br /> ❑SIR testing results(and supporting documentation records). 49mad ❑ Tank gauging results(and supporting documentation records). 4906se <br /> ®ATG Testing results(and supporting documentation records).4906af ❑ Corrosion Protection 60-day logs 490-688 <br /> ®Equipment maintenance and calibration records. 49m n <br /> DL TRAINING <br /> ®Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 490 wa <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) <br /> ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)49m% <br /> ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)49o.69c <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49a69d <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 49m9e <br /> ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND <br /> STATISTICAL INVENTORY RECONCILIATION"490.69r - - <br /> ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490.698 <br /> ❑ OTHER(Specify):tu69n,M69i <br /> This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council(ICC). <br /> The"Designated UST Operator"will train facility employees in the proper operation and maintenance of the UST systems annually,and within 30 days of hire.This <br /> 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 UST Response Plan <br /> ➢ Names of contactperson(s)for emergencies and monitoring alarms.490-7o <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.49 n <br /> Overfill protection method—audiolvisual slant is set at 90%of tank capacity. <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 by <br /> 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 Aldo Basurto 490.72 TITLE Fuel Operations 490.75 <br /> NAME Stan Olea 490%74 TITLE Fuel Operations Manager 490-75 <br /> The 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 <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$ 490-76 DATE: 490.77 <br /> July 1,2009 <br /> APPLICANT NAME(print): 49078 APPLICANT TITLE: 40'79 <br /> Butch Hobson Safety and Environtnental Affairs Manager <br /> UPCF UST-D(12!2007)3/4 <br />