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UNIM'IBD PBOGQAN CONSOLIDATED FORM <br /> UNDERG90UND STORAGE TANK <br /> Y10Nff061NG lt..AN (Pse 2 9(2) <br /> VI.UNDER DiSPLMSER COMAINUVa MDQ MONFITH NG <br /> r9rl5h <br /> 4w-s4b <br /> C(WrlNUOUS USCTRONIC MOX1TOR1N( ❑2.FLOAT ANDC"AIN ASSUMQLY ❑ 3.E1,1 C w)"IC STANNALONN <br /> ❑4.NO DLSPENSUS ❑99-OTHER !YY- ---_-- _ _ <br /> --- -- ------------ --- -- .- -- <br /> a�ss f- /: <br /> PANELMANUFACT(JRFA e,�orj(� --`-- <br /> - ------� .M_ -- — - - ---------- <br /> --._... - .._.. <br /> LEAK SENSOR MANUFACTURER: _ /►1Gr MODEL((S)' <br /> DETECTION Of A LF_AK INTO THE UDC T R"ERS AUDIBUA ND VISUAL ALARMS - ~ - (�—YES D b NO <br /> UDC LEAK ALARM Flit" RS AUTOMATIC PUMP SHUTDOWN IN it.YES C]b NO <br /> f A1LURE I DISCONNLCT(ON Of UDC MONITORING SYSTEM TRIGGERS AUTOMATK( PUMP StitfrDOWN. Rj a.YES ❑b.NO. 4904,1 <br /> _ UDC I�IUNrTORING$POPS THE FLOW OF PRODUCT AT TtiE INSPEMblk 1,YES n b.NO 4W-6Z <br /> z.UDC CONSTI(11CTIOPs 1S ❑I.SINGLE WALED FQ2 DNABL&WALLED """ <br /> IF DOUBLE WALLED: .��.__._._,.,,._....__--------.._....-.-.....__.......,.__,..........,..w.w.._.,_ <br /> �__„-_! !NTFRST1TIAI,SPACFtsMo1+Fr�u1 eY�. �.� �D _Q3-mE oL-03 vACIjow ---------.___.,._.................._._..,.. ......... <br /> j- A LEAK U;Fi1Il THE SEWNDARY COTTTAtNMUIT OF TIE UDC TMUGGN-RS AUO(BLf AND VISUAL ALARMS ❑a.Yt�S�❑b.NO- lit <br /> ' <br /> VM PERJOW SYSTEM TFS 1NG <br /> _ <br /> I. EL kr MS FACILCIY t1AS BEEN NOTA BY THE STATE WATISR RESOURCYs(plrtTtpt.ITOAILU TliwT'13Nt1ANCFD ��''r', <br /> _ t , LON fllnf MUST ff PM'OI MLO. PERKAW ELI)IS PERFORMED EVERY 36 MONTHS AS RLQUIRED. 21 CCR 2644 1 <br /> ❑2.SECONVA0V CONTAINMENTCOMIKINNSMS AM MYM EVMY 36IttloiwnI5 <br /> 3.SIP'II,L RUCI(1 IS Alts TES]”A1NNUA LY- + � <br /> VM. <br /> The following wwWmatiftnimcrorordt ate toot for Ota ACiAry:- <br /> Q A Irm logs 4w4ma ❑Vimal hstutim Rcvath aroaa► ❑Tat alcgty bang molts 4w<* <br /> ❑SIK Testing iciam(aad atpporting docwtna+to m rwwdt). mom Q Tart&agft r%Wu(wW supporting doawgruum rccw& 4w-w <br /> ❑ATG Tesliltg rCStdLS(God s*pwt;mg aacAnaMillioa Tacatd&)-4W-W ❑ Camarioo PnAccum,today)Go*w-w <br /> ❑EWi Zn=ankhWOM 31WClklibtUMN ROVds. 4%a40 <br /> Q I�etsOaap)vriut tu�r atonilarial lcspoasihituirs ae fitnUiar wiW all of the f�+t'►ag dountacass tdevam e��d.tia �-�.� <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Grana A*a MP,*) <br /> ❑ THIS UNDERGROUND STORAGE TANK MIONRORINGPLA14(Rcwited)aaaw <br /> 13 OPERATING MANUALS FDR ELEC-ntONIC MONITORING U?Ulr rILWF(Rcomrcd).a--ua <br /> {] CALIF("IA UNDEW OUND STORAGE TANK RWULATLOMSa>•.r�+ <br /> ❑ CALIFORNIA UNI)F"OUND STORAGE TANK LAW 4r4% <br /> ❑ STATE WATFR RESOURCES CONTROL BOARD(SWRCB) PUBLCATiON: "}IANDROOK FOR TANK OWN W- - MANUAL AND <br /> STATISTICAL INVENTORY RKONCILIATK11hP'assw <br /> CJ S WRCB PUBLICATION:"UNDERSTAND(NG AUTUMATiC TANK GAUpNG SYSTEMS"4w&% <br /> ❑ t711iP1I(Spmdy),mmk Mw ___ <br /> This facility hYS a"Dcsigtnlod UST Opt uue'who IMS pmW tibc Gtldamia UST System Operator Ezana adp4zlsWcd 4 Lha khan liotlal Co&Cotmtcd(1(.'(.'). <br /> Tile .L wd 1w Oparalor"Will train fa6lity erpbyervs in the pseper opmKion and nutua 7lawx of tilt UST syStc ss an Wlly,aid withait 30 drys of hitt.This <br /> training will indadt,bat is not lived to.the(eilkwimg: <br /> Y Apavuon of the UST syr is a with the fatality's bat awwgcrwaa pwaiaa j <br /> > The facility anpioyae'S role Wilk reaanl to the ntWt wxx vwA0vewt as w=Wiicd m dus LIST MocAmme Wan <br /> > The Wlity aA*Vec's rok WAA ntirrard to sills mod osresftihs as speci fit m ft Uhf Rapome Ptan <br /> Y Names of tmmtma pcM*1)AT calwamocus sad atmtwotic tg agoras -v&16 <br /> X, COMMERMADanIONAL HOVA rIATION <br /> Provide addiliorol eetnntans here or indieale how many p fto with wddntic A Wonralion oa apoeibc monitoring proaesOums we allwbW to this pall.4ta-r i----- <br /> TCL PERSONNEL RESPOMMMLY17M <br /> 'Tile UST Ovx=/Opewtor is Ttspotuibk fa cnsw*g that.I)dtc 6ailykattute UST nttanibrisR aCtirilics atrQ mmrwtatioc of U$I iGm OeltctiaT erauipmau covead by <br /> this plan ocaaa,2)all card tics that indicsk a pam ble reimc arc irw lipped,and 3)at)1pWitDrlrla retardf arc mtairkalrattd popRiy, <br /> The following penia)art rcapmsibic[w pafaaa*Ute a ndermg Gad apupsnt w00% ww" <br /> NAME +rst TITLE to-n <br /> NAME 4W14 17TT.E <br /> 'I fie Drsigmucil Optratar aWl pafcm a a®ddy vital iaspatipn of the(acilay,pwvidc a Tcptnt to the owsuhtpcaalot'.Gad idorat Qtt owndaprtnlor of any <br /> conditions&M saM foltovwup action. <br /> XII.OWI•iF.I WIVATUR SICX4TURE <br /> CERTIFICATION:I ratify dw the infmtntim provided herein is riot:mad accaraie to the best ofoay know <br /> APPLICANT SIGNATURE asrtc DATf_• A/- +AW <br /> nt <br /> APPLICANT NAM,(ptW} ArrL1CANT 1 fCL f-- <br /> UPC}lbs--D(12f1N'!1 JM <br /> Ea 39vi 3`1�3S xvi voonN3NNTi,'i Z5Zb9Z95i'L, SB :BT 8130Z19Z180 <br />