COMPLIANCE INFO_2008-2010 - Laserfiche WebLink

Home Browse Search

UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN—(Page 2 of 2) VI UNDER DISPENSER CONTAINMENT C MONITORING. that(Check a[[ UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) C9 1 CONTINUOUS ELECTRONIC MONITORING ❑ 2 FLOAT AND CHAIN ASSEMBLY ❑ 3 ELECTRONIC STAND-ALONE 490-54a El4.NO DISPENSERS ❑ 99.OI_HER(Specify) 490-54b LEAK MONITOR MANUFACTURER: 490-55 MODEL#: 490-56 LEAK SENSOR MANUFACTURER: 490.57 MODEL#(S): 490-58 DETECTION OF A LEAK INIO IHE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS C4 a.YES ❑ b NO 490-59 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN C@ a YES ❑ b NO 490-60 FAILURE/DISCONNECTION OF UDC MONITORING SYSIEM TRIGGERS AUTOMATIC PUMP SHUTDOWN ® a.YES ❑ b NO 490-61 UDC MONITORING STOPS THE FLOW OF PRODUCT AT IHE DISPENSER. a YES ❑ b.NO 490-62 UDC CONSTRUCTION IS: 1 SINGLE WALL ❑ 2 DOUBLE WALL 490-63 IF DOUBLE WALL: 490-64a UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ a LIQUID ❑ b PRESSURE ❑ c VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. ❑ a YES ❑ b.NO 490-64b U�v .p .t ❑ 1 ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65 LEM L)ETgCTIQNLELW MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED.123 CCR§2644.11 _ ® 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490-66 ® 3.SPILL BUCKETS ARE TESTED ANNUALLY. 490-67 The following monitoring/maintenance records are kept for this facility: ago 6s ® a ALARM LOGS ® b VISUAL INSPECTION RECORDS ❑ c.TANK INTEGRITY IESTING RESULT'S ❑ d SIR TESTING RESULTS(and supporting documentation records) ❑ e TANK GAUGING RESULTS(and supporting documentation records) ❑ f ATG TESTING RESULTS(and supporting documentation records) ❑ g CORROSION PROIECTION 60-DAY LOGS �)_h.yE UIPiMENT MAINTENANCE AND CALIBRATION RECORDS "`sP1T { t11:, fJ 1dlr M1T. „.9." •�7i`'43 j.eKf i X Y.V'C"-_hI '1 i':L M} t T ' f' ' 'r•t'. ti:.. - Nl t ,' 4 Y'�:y� .:i✓`5 ; i'4 3x.}:W. _.^ '..-. Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties: 490-69a REFERENCE DOCUMENTS MAINTAINED AI FACILITY(Check all that apply) ® THIS UNDERGROUND STORAGE TANK MONIIORING PLAN(Required) 4"-696 ® OPERAIING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) 490-69c. ®CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490.69d. ® CALIFORNIA UNDERGROUND STORAGE IANK LAW 490-69e. ® STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICAIION: "HANDBOOK FOR TANK OWNERS - MANUAL AND 490-69f- STATISTICAL 90.69ESTATISTICAL INVENTORY RECONCILIATION" (a SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 490.698 E] OTHER(Specify): 490-69h a9o.69i. This 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 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: ➢ Operation of the USI 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 Name(s)of'contact person(s)for emergencies and monitoring alarms �kay...` L4 �.- k-c"• Vel _ � � t .5 2 r1 i '�>5...lir �,`f}�`�, W_ Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan 490-71 x.:.-�"eh..:i�i� ek°�i�;'y`.a.+�»:s- -�'��`�� .f�lik.„� ��✓...;. ..�..,.»e�'t�r� ,��f � >�"��ik�r .^n'��.z 5ay Ma'7�F,. The UST Owner/Operator is responsible for ensuring that: I)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment covered this�lan occurs 2_)all conditions that indicate a Possible release are investigated-.and 3_)all monitoring records are-maintained prp�Y THE FOLLOWING PERSON(S)ARE RESPONSIBLE FOR PERFORMING THE MONITORING AND EQUIPMENT MAINIENANCE: NAME: T T,�� 490-72 TITLE: —. - n 490-73 NAME: 490-74 TIRE: 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 owner/operator of any conditions that need follow-up action. - *..._ ' XIII:` OWNER/OPERATOR$IGN.4TURE CERTIFICATION:I certify that the mation povided,4erSln is true and accurate to the best of my knowledge. APPLICANT SIGNATURE DATE: 490-77 F EPRESENTINQ El 1.I'anh Owner/ i Facili 0 / orator .Authorized R resentadve of Owner 490-76, PPLICAN NAME(print): 490-78 APPLICANT TITLE• 4�79 UPCF UST-D(12/2007)-3/4 www.unidocs.org