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MAR-13-2008 11:57A FROM: TO:4683433 P.3 UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN (Page 2 of 2) VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING 490-540- 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-54b ❑ 1.CONTINUOUS ELECTRONIC MONITORING 012.FLOAT AND CHAIN ASSEMBLY ❑ 3-ELECTRONIC STAND-ALONE ❑4.NO DISPENSERS ❑99.OTHER(Specify}: PANEL MANUFACTURER: 490-11 MODEL : 490-56. LEAK SENSOR MANUFACTURER: 490:1_7 MODEL#(S): 490-58 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑ a.YES ❑b.NO 490.59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ❑ a.YES ❑b.NO 490'60 FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑b.NO 490-61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER ❑ a.YES ❑b.NO 490.62 2.UDC CONSTRUCTION IS C91.SINGLE-WALLED ❑2.DOUBLE-WALLED 490.63 IF DOUBLE WALLED: 490.64a UDC INTERSTITIAL SPACE IS MONITORED BY: ❑1.LIQUID ❑2.PRESSURE [13.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO 49O'60.b VII.PERIODIC SYSTEM TESTING 1, ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 499.65. LEAK D ECT10 ELD MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS RgQUIRED. 23 CCR 2644.1 1R2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 49"6 U{3.SPILL BUCKETS ARE TESTED ANNUALLY. 499.67 VIII.RECORDKEEPING The following monitoring/maintenance records are kept for this facility: Alarm logs 490.660- aff Visual Inspection Records 490.68b ❑Tank integrity testing results 490.6sc SIR testing results(and supporting documentation records). 49048d ❑ Tank gauging results(and supporting documentation records). 490-6se ATG Testing results(and supporting documentation records).ago-68f ❑ Corrosion Protection 60-day logs 490-6sg RQ tsquipment maintenance and calibration records. 49o.68h IX.TRAINING Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 490.690- REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) ja THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490.69b ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490.690 CK CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490.69d ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 490.69* ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL INVENTORY RECONCILIATION"490.69f ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"ago-698 ❑ OTHER(Specify),M6%.M69i 19 This 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-. D 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 Pian Names of contact person(s)for emergencies and monitoring alarms.490-70 X. COMMENTS/ADDITIONAL INFORMATION Provide additional comments here r indicate how manFps ithadditional informatic"^"a"nniA,monitoring pr ores are attached to this plan.490-71 XI.PERSONNEL RESPONSIBILITIES 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 this plan occurs,2)all conditions that indicate a possible release are investigated,and 3)all monitoring records are maintained properly. The followson(Jame rrs onsisible for performing the monitoring and equipment maintenance: NAME 490-72 TITLE 490-73 NAME �j�j' 10, 490-74 TITLE 490-75 The Designated Operator shall perform a monthly visual inspection of the facility,provide a report to Am owner/open r,and inform the owner/operator of any conditions that need follow-up action. XII.OWNER/OPERATOR SIGNATURE CERTIFICATION:I certify that the information Rrovided herein is true and accurate to the best of my knowledge. SIGNATURE 49o-76 DATE: 0-900-7 L. 3 ' 13 +20 0 $ RFPR&SEN[7NG❑t T{glj Ovmff(jlQyraror 2 Faed ReoresenfafiveofQwner APPLICANT NAME(print): 4 78 APPLICANT TI 490 to r Q- e,1LcTLA I1PCF