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:Zz;a •r::::.ti: ::::i�z:_�'h'kms:-s'�?E?� •kRkk A vA1� ..___..si:..s:........:........r„ —-------.._--_-- <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN (Page 2 of 2) <br /> VI.UNDER.DISPENSER CONTAINMENT(UDC)MONITORING <br /> 490-54a <br /> 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-54b <br /> ® 1.CONTINUOUS ELECTRONIC MONITORING ❑2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE <br /> ❑4.NO DISPENSERS [199.OTHER(Specify): <br /> PANEL MANUFACTURER:Veeder Root 49055 MODEL#:TLS 350 — 490-6' <br /> LEAK SENSOR MANUFACTURER:Veeder Root ago-s7 MODEL#(S):208 490-59 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ® a.YES El 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 49062 <br /> 490-63 <br /> 2.UDC CONSTRUCTION IS ®I.SINGLE-WALLED ❑2.DOUBLE-WALLED _ <br /> 490-64a <br /> IF DOUBLE WALLED: <br /> UDC INTERSTITIAL SPACE IS MONITORED BY: ❑1.LIQ ❑2.PRESSURE ❑3.VACUUM ______ <br /> ----UDC IN— - _— ----- -----^-------------------------- - 490-64b <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO <br /> VII.PERIODIC SYSTEM TESTING <br /> ❑ 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65. <br /> LEAK DETECTION(ELD)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. ——_-----____-------- 4 -66_ <br /> ®3.SPILL BUCKETS ARE TESTED ANNUALLY. 490-67 <br /> VIII.RECORDKEEPING <br /> The following monitoring/maintenance records are kept for this facility: <br /> ®Alarm logs 490.69& ®Visual Inspection Records 490.69b ❑Tank integrity testing results 490-69e <br /> ❑SIR testing results(and supporting documentation records). 490-69d ❑ Tank gauging results(and supporting documentation records). 490-69e <br /> ®ATG Testing results(and supporting documentation records).490-69f ❑ Corrosion Protection 60-day logs 490-69g <br /> ®Equipment maintenance and calibration records. 490-69h <br /> IX.TRAINING <br /> ®Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 49069a <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)490.69e <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-69e <br /> ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND <br /> STATISTICAL INVENTORY RECONCILIATION"490-69f <br /> ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490-69g <br /> ❑ OTHER(Specify):M69h,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 contact person(s)for emergencies and monitoring alarms.49070 <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.490-71 <br /> o,P_rC,-y\)C- U&( (,Me— Oveti.f"11 <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 Nick Patel 49072 TITLE Manger <br /> 490-73 490-75 <br /> NAME 49074 TITLE <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 SIGNATURE 490-76 DATE: 490-77 <br /> 03/20/2014 <br /> R PRE ENTING: I Tank wner/ erator 2.Facifi wn r/0 erat r 3.Authorized Re re entativ of wn r 490-79 <br /> APPLICANT NAME(print): 450-70- APPLICANT TITLE: <br /> Nick Patel Manager <br /> -TW—V rtoT p_rr�n��i;fit <br />