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AIL NIFIED PROGRAM CONSOLIDATED FORMW— UNDEGO UND STORAGE TANK MONITORING PLAN (Page 2 of 2) VL UNDER DISPENSER CONTAINMENT(UDC)MONITORING 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-54a )K 1.CONTINUOUS ELECTRONIC MONITORING 0 2,FLOAT AND CHAIN ASSEMBLY [1 3.ELECTRONIC STAND-ALONE 490--qb 04.NODISPENSERS [399.OTHER(Speci ): PANEL MANUFACTURER- ODEL#: 49456. LEAK SENSOR MANUFACTURER: Vie 4e490.97 MODEL#(S). --------------—----------— 49494 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS 0 a.YES J9 b.NO 49(39 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN rff a.YES Fl b.NO 490-60. FAILURE I DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. %a.YES [I b.NO 490-61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. 19 a.YES El b.NO 490-62 2.UDC CONsTRUCrioN is 0,SINGLE-WALLED 0 2.DOUBLE-WALLED 490-63 IF DOUBLE'%-*ALLED- — UDC INTERSTITIAL SEtACE IS MONITORED A LEAK WIT14IN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS-—0a.Y7jS-j rbN—O ----490-64b VIT.PERIODIC SYSTEM TEST G 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BYTHESTATE WATER RESOURCES CONTROL KUL BOARD THAT ENHANCED 490-65, LEAK DETECTION MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS R_91 (23CCR,-,�j.l) 192.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS 3.SPILL BttCKETS ARE TESTED ANNUALLY. 490-67 V111. CO KEEPING The following monitoring/maintimance records are kept for this facility: IM Alarm logs 490-680- fXVisual Inspection Records 49o*sb J9Tank integrity testing results 4❑ 9o-6sc SIR testing results(and supporting documentation records). 490-W [I Tank gauging results(and supporting documentation records). 490-680 ❑ATG Testing results(and supporting documentation records),49"itr [I Corrosion Protection 60-day logs 49"ag Equipment maintenance and calibration records. 4"4sh IX.TRAINING JgPersonnel with LIST monitoring responsibilities am familiar with all of the following documents relevant to their job duties. 490 694 REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) 19 THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)49o4% OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required). 49o-69c ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49( 69d CALIFORNIA UNDERGROUND STORAGE TANK LAW 49049* 0 STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS MANUAL AND STATISTICAL INVENTORY RECONCILIATION-490-W 13 3 C PUBLICATION-"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS'490.698 0 OTHER(Specify):w90-,N69i JBIUS facility has a"Designated UST Ope '1 i !!1 has 1s xMillsed the Califbmia UST System opemtcliii'll�:::��!!ii��"il'�:iii'l!i'i,i'i�administered......... by the international Code Council(ICC). The"Designated UST Operator"will train facility employee's in the proper operation and maintenance or 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 equipmentif in UST Monitoring Ian • The f8cilitY employee's role with as specified this sponse P regard to spills and overfills as specified in the UST Re Plan • Names of contact per-sch(s)for emergencies and monitoring alarms.490.70 X. COMMENTS/ADDITIONAL INFORMATION Provide additional comments here or indicate how many pages wvith additional information on s�ei6c monitoring procedures are attached to this plan,49041 ca XL PERSONNEL RESPONSIBILITIES The UST 0%vner/Operator is responsible for ensuring that:1)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment covered b this plan occurs,2)all conditions that indicate a possible release are investigated,and 3)all monitoring records are properly. y The followin person(s) 0 responsible for pe r9c maintained pe NAME performing the monitoring and equipment mamtenanc NAME 490 72 TITLE ;7 45*4441 TITLE I 490-13 The Desi ed Operator If peai l'11101 fiEmItly visual—inspection of the faciii49049 conditions that follow-up action ItY, P1 l�:1 ii de a report t the owner/operator,and inform the r/operator of any XIL OWNER/OPE RATOR SIGNATURE CERT CATION: rtify dW the information vidled herein is true and accurate to the best 017my k APPLIC SIGN RE nowledge. = 490-76 DATE: 490-77 11 A PPLICANT NAME(print): 49(09 APPLIC NT TITLE: 49(19 UPCF UST-D(1120 07)3/4