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UNIFIED PROGRAM CONSOLIDATED FORA& UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) V1.UNDER DISPENSER CONTAINMENT*DC)MONITORING 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-544 490-546 El 1.CONTINUOUS ELECTRONIC MONITORING El 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE Z 4.NO DISPENSERS E:199.OTHER(Specify): PANEL MANUFACTURER: MODEL#: 490-56. ------------------------------------------------- - ----------------- LEAK SENSOR MANUFACTURER: : MODEL#(S) 490-58 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS El a.YES 0 b.NO 490-59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN El a.YES 0 b.NO 490-60. FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. El a.YES El b.NO 490-61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. 11 a.YES 0 b.NO 490-62 2.UDC CONSTRUCTION IS [_1 1.SINGLE-WALLED []2.DOUBLE-WALLED 490-63 IF DOUBLE WALLED: 490-644 UDC INTERSTITIAL SPACE IS MONITORED BY: El 1.LIQUID [12.PRESSURE [13.VACUUM ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS D a.YES El b.NO 490-64b VU.PERIODIC SYSTEM TESTING M 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65. ----------- LEAK-DETECTION JELD)MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED.(23 CCR§2644.1) ------- [12.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490-66 3.9-Fifi Tf§ifff_X��IUXfj:V7---------------------------------------------------------------------------------------------------------------------------------------------4-9--0--6-7-- VIII.RECO"KMPING The following monitoring/maintenance records are kept for this facility: 0 Alarm logs 490-68a F-1 Visual Inspection Records 490-68b ❑Tank integrity testing results 490-68c El SIR testing results(and supporting documentation records). 490-68d ❑ Tank gauging results(and supporting documentation records). 490-68e F1 ATG Testing results(and supporting documentation records).490-68f El Corrosion Protection 60-day logs 490-68g Equipment maintenance and calibration records. 490-68h JX.T"INING ED Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 490-6% REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) 0 THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490-69b OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490-69C ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d El CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-69e F-1 STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS MANUAL AND STATISTICAL INVENTORY RECONCILIATION"490-69f ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490-69g ❑ OTHER(Specify):M69h,M69i This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council(ICC). 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 training will include,but is not limited to,the following: > Operation of the UST systems in a manner consistent with the facility's best management practices > The facility employee's role with regard to the monitoring equipment as specified in this UST Monitoring Plan > The facility employee's role with regard to spills and overfills as specified in the UST Response Plan > Names of contact person(s)for emergencies and monitoring alarms.490-70 X. COM MENT'S/AODITIONAL INFORMATION Provide additional comments here or indicate hop many pages with additional information on specific mon kor;ng rocedures;are attached to tl�iIS plan.490 Ik IL Jp 71 01� ov% *M4. v%s v(0 &\Qv rV% boAk ®® %S -0(^XL.PERSONNEL,REOONSIBILITIES 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 this plan occurs,2)all conditions that indicate a possible release are investigated,and 3)all monitoring records are maintained property. The following person(s)are responsible for performing the monitoring and equipment maintenance: NAME RA0101f po6Klxt__0 490-72 TITLE j,)416p_VtScp_ 490-73 NAME 490-74 TITLE 490-75 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 conditions that need follow-up action. XII.OWNEW iR,SIGNATURE�,,�',`,,,'� CERTIFICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. APPLICANT SIGNATURE 490-76 DATE: 490-77 LREPRESENTING: 3 1-Tank Owner/Awk 3 2.Facility Oner/Operator r-3 3.Authorized Re resentative of ner 9 APPLICANT NAME(print): 490-78 APPLICANT TITLE: 490-79 S4 ITO 5Aa1LXnE-75 tANJ"Wt_VSr UPCF UST-D(12/2007)3/4