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ARL UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK • MONITORING PLAN (Page 2 of 2) VI UNDER DISPENSER CONTAINMENT(UDC)MONITORING 1. UD MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-54a 490.546 CONTINUOUS ELECTRONIC MONITORING ❑2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE ❑4.NO DISPENSERS ❑99.OTHER(Specify): 90-55 PANEL MANUFACTURER: 1j G �( 4MODEL#_ --s-S-0 490-56. LEAK SENSOR MANUFACTURER: 490-57 MODEL#(S): -- 490-58 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑ a.YES ❑b.NO 490-59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ❑ a.YES ❑b.NO 490-60. FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑b.NO 490-61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ❑ a.YES ❑b.NO 490.62 2.UDC CONSTRUCTION IS 1.SINGLE-WALLED ❑2.DOUBLE-WALLED 490-63 IF DOUBLE WALLED: 490-64a UDC INTERSTITIAL SPACE IS MONITORED BY: [11.LIQUID ❑2.PRESSURE ❑3.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO 490-64e VII.PERIODIC SYSTEM TESTING ❑ 1. ED TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65. EAK DETECTION ELD MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED.(23 CCR§2644.1 2 CONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490-66 3.SPILL BUCKETS ARE TESTED ANNUALLY. 490-67 11 - VIII.RECORDKEEPING The owm gmonito(n mapponancge records are kept for this facility: „.. g S/ P ty. Alarm logs 490-68a Visual Inspection Records 49-686tegrity testing results 490-68c SIR testi) results and supporting documentation records 490-680- rPa.n�kgauging results(and supporting documentation records). 490-68e ❑ AX Testing results(and supporting documentation records).490-68f ❑ Corrosion Protection 60-day logs 49068g Equipment maintenance and calibration records. 490-68h IX.TRAINING ❑Personne it" UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 490-69a REFERCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) i 2r UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490-69b ING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490-69c IFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-69e ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"490-69f ❑ S B PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490-69g THER(Specify):M69h,M69i [ErThis 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 A 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 A Names of contact person(s)for emergencies and monitoring alarms.490-70 X. COMMENTS/ADDITIONAL INFORMATION Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan.49o-7i M.PERSONNEL-RESPONSIBILITIES, 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 properly. The foltowi�g P�n(s)X3,s ibl or p�rf in$the monitoring and equipment maintenance: NAME J 1T 1-- j- N� V 490-72 TITLE 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.O WOPERATOR SIGNATURE CERTIFICATION:I certify that th�ation provided herein is true and accurate to the best of my knowledge. APPLICANT SIGNATURE 490-76 DATE: 490-77 `-1 [ 10 RE RE ENTIN r . Facility r/ r Q 3.AWhgiJZgd&W[MpJ9vgf Qweer APPLICANT NAME(print): _ 478 APPLICANT TITLE: 49-79 l -S 1-- f-C — UPCF UST-D(12/2007)3/4