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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING -54 1.)JDC MONITORING IS PERFORMED USING rWC LOWING 13AV490 METHOD A- ,0 490-54b )E ,01 CONTINUOUS ELECTRONIC MONITORING T AND CHAIN ASSEMBLY 0 3.ELECTRONIC STAND-ALONE ❑4.NO DISPENSERS 0 99.OTHER(Specify): /-S PANEL MANUFACTURER: ZN C&A)r 4-11 1 MODEL#: 490-56 LEAK SENSOR MANUFACTURER: ; - 7m6vA2 490-11 1 MODEL#(S): 7 vt— 490-58 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS [3 a.YES 0 b.NO 490-59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN 0 a.YES 0 b.NO 490-60. FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. [I a.YES C1 b.NO 490-61 UDC MONITORING STORS THE FLOW OF PRODUCT AT THE DISPENSER 0 a.YES 0 b.NO 490-62 2.UDC CONSTRUCTION IS ffl.SINGLE-WALLED 0 2.DOUBLE-WALLED 490-63 IF DOUBLE WALLED: 490-6aa UDC INTERSTITIAL SPACE IS MONITORED BY: [3 1.LIQUID Q 2.PRESSURE C]3.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS 13&YES 0 b.NO 4—b VII.PERIODIC SYSTEM TESTING [3 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT EMI&NM 49"5. LE"DETEQ=,(ELPJ MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED.(23 CCR 2644.1 SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490-66 A3.SPILL BUCKETS ARE TESTED ANNUALLY. 490-67 VIII.RECORDKEEPING The following monitoring/maintenance records are kept for this facility: RAlarm logs 49068a 0 Visual Inspection Records 490-69b Q Tank integrity testing results 49o-6ac SIR testing results(and supporting documentation records). 490-68d LJ Tank gauging results(and supporting documentation records). 49o-6se ATG Testing results(and supporting documentation records).49o-6sf [3 Corrosion Protection 60-day logs 4go-6sg P'Equipment maintenance and calibration records. 490-68h IX 11LAINING IN Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 490-69a REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)4W.69b OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)49o-69c CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49o-69d CALIFORNIA UNDERGROUND STORAGE TANK LAW 49"% STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"490-69f [3 SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"49o-69g 0 OTHER(Specify):m69h,m6% aThis 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.49D-7o X COMIMIENTSIADDITIONAL INFORMATION Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan.49D-71 A e- P06 0/2( A— M.PERSONNEL RESPONSIBILITIES The UST ;M%r�)s responsible for ensuring that:1)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment covered by conditions 0� d thisplan(=curs,42q7a ditions that indicate a possible release are investigated,and 3)all monitoring records are maintained properly. The following person(s)are responsible for performing the monitoring and equipment maintenance: NAME 4go-72 TITLE 490-73 NAME 49o-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 ownedoperator of any conditions that need follow-up action. XII.OWNE PER ATO CERTIFICLT4PN:I certify that the information Mvided herein is true anaccurateto the best of my knowledge. APPLICANT Sq*ATURE 490-76 DATE: 490-77 -Ix REIRES 0 3.AVAgfixd Ranolling of 1 APPLICADF NAME(print): 490-78 APPLICANT TITLE: 4907 9 UPCF UST-D(12/2007)3/4