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i <br /> FLED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN (Page 2 of 2) <br /> 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-54 <br /> 490-546b <br /> ❑x 1.CONTINUOUS ELECTRONIC MONITORING ❑2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE <br /> ❑4.NO DISPENSERS ❑99.OTHER(Specify):-- _ <br /> PANEL MANUFACTURER: Beaudreau 490-55_ MODEL#: TLS-350R 490-56. <br /> LEAK SENSOR MANUFACTURER: Beaudreau �— _ _ 490 57 MODEL#(S):406!508 --- 490-59 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ® a.YES ❑b.NO 490-59 <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ® a.YES O b.NO 490-60 <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a-YES Zj b.NO 490-61 <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ® a.YES ❑b.NO 490-62 <br /> 2.UDC CONSTRUCTION IS El 1.SINGLE-WALLED ❑ 2.DOUBLE-WALLED 490-67 <br /> IF DOUBLE WALLED: 490-64a <br /> UDC INTERSTITIAL SPACE IS MONITORED BY: C1 1.LIQUID ❑2.PRESSURE [13.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES— ❑b.NO 4`w-6ab <br /> �II'PI+:RIUDIG SI' TE1Vt BESTING 3 s..., <br /> ❑ 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65. <br /> LEAK DETECTION(ELD.MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS—REQUIRED.—(23 CCR-§2644.-I)--------. <br /> ®2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490-66 <br /> ®3.SPILL BUCKETS ARE TESTED ANNUALLY. 490-67 <br /> r h _£ ! r 4+rt <br /> tr" <<;,r��,,�`7I�,a,'t4`nai t,,l<j4 ,1+t�{;{i}:1{�rrrl zYcSiF f i ,E~,w,:�,VIII RECURDKEEPING,.,. ' '" , 6�; ;i' s` ` i:<•: <br /> The following monitoring/maintenance records are kept for this facility: <br /> ®Alarm logs 490-68a ❑Visual Inspection Records 490.686 ❑Tank integrity testing results 490-68c <br /> ❑SIR testing results(and supporting documentation records). 49"Ild ❑ Tank gauging results(and supporting documentation records). 490-698 <br /> ❑ATG Testing results(and supporting documentation records).490.611f ❑ Corrosion Protection 60-day logs 490-68g <br /> ®Equipment maintenance and calibration records. 490-6ah <br /> yi i r �Pif3 ° 'd '}t, d✓.h Ai t�+ f t!s �;, i b t iy t , a" .f f gi r <br /> � tRt� NiNG <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 /> ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)49"9b <br /> ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490-69c <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-69, <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 /> Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan.490-71 <br /> Fill Sump Sensors:Veeder Root 794380-208 <br /> Overfill Protection:Drop Tube Flapper <br /> 014 tf,, i < tt:;4 • t,,, Ir. r'' "XI PERSONNEL''RESPONSIBILI I IES +. <br /> The UST Owner/Operator is responsible for ensuring that: I)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 responsible for performing the monitoring and equipment maintenance: <br /> NAME Javier Arellano 490-72 TITLE MANAGER 490-73 <br /> NAME Steve Darretta 490-74 TITLE General Manager 490-75 <br /> The Designated Operator shall perform a monthly visual inspection of the facility, provide a report to the owner/operator, and inform the owner/operator of any <br /> conditions that need follow-up action. <br /> "kXII.OWNT•}R%OPEItATUR``SIGNAPURE+•: <br /> CER FI ON:I certify that t info ti provided herein is true and accurate to the best of my knowledge. <br /> LICA GNATU 490-76 BATE: 490 77 <br /> January 5,2010 <br /> 3�A.IILI il, <br /> APPLIC T NAME(print 440-79 APPLICANT TITLE: 490-79 <br /> Aura Sibley for Shell it ducts HS&E Compliance Coordinator <br /> UPCF UST-D(12/2007)2/5 <br /> 4 <br />