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UNIFIED PROGRAM CONSOLIDATED FO <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN (Page 2 of 2) <br /> VL UNDER DISPENSER CONTAINMENT(UDC)MONITORING <br /> 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-54$ <br /> 490-54b <br /> 1.CONTINUOUS ELECTRONIC MONITORING ❑2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE <br /> 4.NO DISPENSERS 1199.QTHER(Si ): <br /> PANEL MANUFACTURER: 4t0 55 MODEL#: — 490-56, <br /> LEAK SENSOR MANUFACTURER: 490.57 1 MODEL#(S): D (MI) 490.58 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS a.YES 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 IHE FLOW OF PRODUCT AT THE DISPENSER a.YES ❑b.NO 490-62 <br /> 2.UDC CONSTRUCTION IS SINGLE-WALLED ❑2.DOUBLE-WALLED 490-63 <br /> IF DOUBLE WALLED: 490.64a <br /> UDC INTERSTITIAL SPACE IS MONITORED BY: 1.LIQUID Q 2.PRESSURE 13 3.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO 490-64b <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 /> MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED. 23 CCR 2644.1 <br /> R2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490-66 <br /> SPILL BUCKETS ARE TESTED ANNUALLY. 49067 <br /> VIII.RECORDKEEPING <br /> e following monitoring/maintenance records are kept for this facility: <br /> Alarm logs 490.68a ❑Visual Inspection Records 490.68b ❑Tank integrity testing results 490680 <br /> ❑SIR testing results(and supporting documentation records). 490.68d ❑ Tank gauging results(and supporting documentation records). 49o-68e <br /> ❑ATG Testing results(and supporting documentation records).4968f ❑ Corrosion Protection 60-day logs 49"sg <br /> ❑Equipment maintenance and calibration records. 4go-m <br /> IX.TRAINING . <br /> V.Personnel with UST monitoring responsibilities are familiar with all ofthe following documents relevant to their job duties. 490-69a <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) <br /> THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)49069b <br /> OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490.690 <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49o-69d <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 49"% <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):M69b,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 /> We"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.490-70 <br /> X. CONIMENTSIADDITIONAL 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 /> (d' eWAg��M <br /> XI.PERSONNEL RESPONSIMATIES <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 490-72 TITLE I� 490-73 <br /> NAME 49o-74 TITLE 490-75 <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.O R/OPERATO SIGNATURE <br /> CERTIFICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. <br /> APPLICANT OGNATURE 490-76 DATE: <br /> 490.77 <br /> RFVRFSENTING'O 1 Tan{:Owner/Operator O 2 Faeili[LIL01,—❑3 Arborized Reoresadative of Owner <br /> APPLICANT NAME(print): 490.78 APPLICANT TITLE: 490-79 <br /> UPCF UST-D(12/2007)3/4 <br />