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M., UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN-( a e 2 of 2) VI. UNDER DISPENSER CONTAINMENT(UDC)MONITORING (Check'a-11 UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) �1.--.,.�I y]) 0 1.CONTINUOUS ELECTRONIC MONITORING E] 2.FLOAT AND CHAIN ASSEMBLY [13.ELECTRONIC STAND-ALONE 4%-540- 4,NO DISPENSERS ------------------ [ 99m OTHER(Specify) 490-54b. LEAK MONITOR MANUFACTURER: 490-5-5 MODEL#: 490-56.- LEAK 90-5&LEAK SENSOR MANIUFACTURER: 490.57- MODEL#(S): 49458. DETECTION OF A LEAK INTO THE.UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. 11 a.1 ES ❑ b.NO 490-59. UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN. [] a.YES ❑ b.No 490-6D. FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. El a.YES E] b.NO 490-61. UDC MONITORING STOPS THE FLOW Or,PRODUCT ATTHE DISPENSER. El a.YES [:] b.NO '0-62- UDC CONSTRUCTION IS: ❑ 1.SINGLE WALL ❑ Z DOUBLE WALL 49063. IFDOUBLEWALL: UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ a.LIQUID ❑ b-PRESSURE ❑ c,VACUUM 490-64& A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. ❑ a.YES [] b.No 490-"b I. PERIODIC S iTEM-TESTING U 1.ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 49PX- -gj- LLAK DETECUQMLE-L-DI MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED.[23CCR§26".Ij 2--SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490-66. Ej 3-SPILL BUCKETS ARE TESTED ANNUALLY. 490-67. VIII. RECORD KEEPING The following monitoring/maintenanec records are kept for this facility: 00468. 0 a.ALARM LOGS n b.VISUAL INSPECTION RECORDS n c.TANK INTEGRITY TESTING RESULTS 0 d.SIR TESTING RESULTS(and supporting documentation records) 0 e.TANK GAUGING RESULTS(and supporting documentation records) ❑ f,ATG TESTING RESULTS(and supporting documentation records) 0 g.CORROSION PROTECTION 60-DAY LOGS h.EQUIPMENTMAINITENANCE AND CALIBRATION RECORDS IX. TRAINING 0 Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties; 49"9& REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that appy) 0 TIES UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 490-69b. 19 Ol'ERAJING MANIJALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) 490-69c. 11 CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69,1 [I CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-6 %. 0 STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND 490.69f STATISTICAL INVENTORY RECONCILIATION" 0 SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 490.69s. 0 OTHER(Specify): 490-69k 490-69i. -UThis facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council 490-70. (ICC). The 'Designated UST Operator"will train facility employ=in the proper operation and maintenance ofthe 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 facility's UST Response Plan. Names)of contact person(q)for emergencies and Monitoring alarms. 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. 490-71. XI. PERSONNEL RESPONSIBILITIES The UST Owncr/Operata,is responsible for ensuring that; 1.)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment byfl!isp4an covered plan 2.)all conditions that indicate a Possible release are investjEoteo;and 3.)at properly v THE FOLWING PERSON(S)ARE RESPONSIBLE FOR PERFORMING THE MONITORING AND EQUIPMENT MAINTENANCE: RMI TE ANCE 490-72. TITLE: 490-73. 490.74- TITLE: 490-75 The Designated UST Operator shall perform a monthly visual inspection of the facility,provide a report to the owner/operator,and inform the own - conditions that need follow-up action. owner/operator of any X11- OWNER/OPEOR SIGNATURE CERTIFICATION:I cerdfV that the information provided herein is true and accurate to the best of my knowledge. APPLICANT SIGNATURE DATE: 490-77. I /-, eT17. Q 3,Audmized EMMentafiw ofowma 490-76 APPLICANT NAME(print): 490-78. APPLICANT TITLE: 490-79. 6C^V-k-!E4e - UPCF UST-D(1212007)-3/4 www.unidecs.org