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UNIFIED PROGRAM CONSOLIDATED FO <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN (Page 2 of 2) <br /> VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING <br /> 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-54a <br /> 490-546 <br /> 1.CONTINUOUS ELECTRONIC MONITORING ❑2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE <br /> ❑4.NO DISPENSERS ❑99.OTHER(Specify): _— <br /> PANEL MANUFACTURER: �(,O 490-ss 1 MODEL#: 490-56. <br /> LEAK SENSOR MANUFACTURER: ~� 490.57 1 MODEL#(S): 490.58 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS _kr a.YES ❑b.NO 490.59 <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN 9'a.YES ❑b.NO 490-60. <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. Era.YES ❑b.NO 490-61 <br /> UDC MONITORING STOPS THE FLOW OF PRODUCTAT THE DISPENSER. a.YES ❑b.NO 490-62 <br /> 2.UDC CONSTRUCTION IS ❑l.SINGLE-WALLED 2.DOUBLE-WALLED 490-63 <br /> ---------- <br /> IF DOUBLE WALLED: 490-648 <br /> — UDC INTERSTITIAL SPACE IS MONITORED BY: I.LIQUID ❑2.PRESSURE ❑3.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS a.YES ❑b.NO 490-646 <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 /> LE K D TE TI N LD MUST BE PERFORMED_PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED.-23 CCR 2644.1 <br /> 3.�SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS 490-66 <br /> -- ------------------------------------------------------------------------------------------------------------------------ <br /> 3.SPILL BUCKETS ARE TESTED ANNUALLY. 490.67 <br /> VIII.RECORDKEEPING <br /> following monitoring/main nance records are kept for this facility: <br /> Th <br /> Alarm logs 490-68a Isual Inspection Records 490.68b ❑Tank integrity testing results 490-69c <br /> ❑,SIR testing results(and supporting documentation records). 490-68d ❑ Tank gauging results(and supporting documentation records). 490-68e <br /> ATG Testing results(and supporting documentation records).490-68f ❑ Corrosion Protection 60-day logs 490-688 <br /> ❑Equipment maintenance and calibration records. 490-68h <br /> IX.TRAINING <br /> ❑Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 490-69a <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) <br /> 91,THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490-69b <br /> OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490-69c <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490.69d <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-69e <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):M69h,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 /> 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 <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. COMMENTS/ADDITIONAL 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 /> XI.PERSONNEL RESPONSIBILITIES <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 res onsible for performing the monitoring and equipment maintenance <br /> NAME =:V,49-A.J Z.Cs/h PiA eL 490-72 TITLE ��1q6 X61C 490-73 <br /> NAME J 490-74 TITLE �yG 7—`- �f39��/��e es9IZDs 490.75 <br /> The Designated Operator shall perform a monthly visual inspection of the facility, provide a reportto th owner/operator,and inform the owner/operator of any <br /> conditions that need follow-up action. <br /> XII.OWNER/OPERATOR SIGNATURE <br /> CERTIFICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. <br /> Appl, ' �1T 490-76 DATE: <br /> 490.77 <br /> ❑ ❑ Facility w e/ 'v <br /> APPLICANT NAME(print 490-78 APPLICANT TITLE: 490-79 <br /> UPCF UST-D(12/2007)3/4 <br />