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AM • UNIFIED PROGRAM CONSOLIDATED FO UNDERGROUr4D STORAGE TANK MONITORING 2 of 2) VI.UNDER DISPENSER CONTA G 49asaa 7- 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHODasas4c CONTINUOUS ELECTRONIC MONITORING ❑2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE ❑4.NO DISPENSERS ®99.O S MODEL#: 4�ss a�%_ PAEM��NUFA MODEL#(S): C�SORCTURER: 0-upf" ��t YES ®b.NO as9 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL S ttj a.YES ❑b.NO a0 UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC pump SHurDowic a YES E3 NO 490-62UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER 490-63 2.UDC CONSTRUCMON IS 04.SINGLE-WALLED ❑2. 490-64a 1F DOUBLE-WALLED- UDC INTERSTITIAL SPACE IS MONITORED BY: t.L UID 2 PRESSURE 3.VACUUM A LEAK THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ®a YES ❑b.NO VII.PERIODIC SYSTEM TFffMG i. EI,D G:THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES t�)NTROL BOARD THAT_EIWANCED a NaMMUSTBEPERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS UIRED. 23 CCR2644.1 a 90-66 17� SECONDARY T COMPONENTS ARE EVERY 36 MONTHS. 2. 0-90.67 SPILL BU ARE ANNUALLY, VUL O PING The foil owiug records are kept for this facility: JgLtJarrn JOSS a isual on Records 49o4sb ! Y les 8 results 490-M on records). 0-90 sse lnSIR (eSUILi( records). 490-M Tank results(sial supportingl ATG T is(end [tg tttgum records).490•csr [3 Conwm Protection 60-day o F,quand call . 490-m IX.TRAUQNG ❑ amidwith UST ounittoring responsibilitiesare familiar with all of the following relevant to their job duties. 49069a REFERENCE DOCUMENTS MAINTAINED AT FACH=(Check all&M apply) UNDERGROUND STORAGE TANK MONITORING PLAN( ) PERATtAiG MANUALS ELECTRONIC MONITORING EQ (Required) ORNIA GROUND STORAGE TANK REGULATIONS UNDERGROUND STORAGE TANK LAW avacso ❑ STATE WATER CONTROL BOARD (SWRCB) PUBLICATION: -HANDBOOK FOR TANK OWNERS - MANUAL AND STATISTICAL Y RECONCII.IATION"a90.69r ® SWRCB PUBLICATION:" ANDING AUTOMATIC TANK GAUGING SYS ❑ OTHER(SPecifY)- Exam administered try the Cie Council(ICC). is fact has a" UST who has passed the C alifomia UST System The" UST win facility employees in and of the UST systems ttntttmlly,and within 30 days of hire.This Destnafted raining will incites,but u 1' to,the following: p of the UST in a consistent with the fncility's Plawangewgmpracdm n ➢ The fncility ogee's mk Witt to tm monitoring equipment as . in this UST ➢ The fatality 's itis with regard to spills and overfills as in the UST Response Plan ➢ Mart of s)f� - and motitoring alarm.a90.7o X, CO ADDITIONALEqFORMATION es with additional info on specific ring are to tris plan.490-7 t Provide 192e,or indicatehow wrathy gag � t t XL P N '•es and maintenance of UST leak detection equipment covered by The UST is bis for ensuring that:1)the oily UST moi this plan occurs,2)all conditions that indicate a possible release are investigated,and 3)all monitoring records are maintained properly. The foil s)are -ble for orming the monitoring and 490-73 NAME Q 49D-72 TITLE 490.74 TTILE owns NAME n of lite facility,provide a to the owner/ ,atui inform the owner/operator of any The Desi s)mll a ttmnthly visual inspectio conditions that need follow-up XII.OwNER/OPERATOR SHWATURE C"EN:I the information ided herein is lure and to the best of my knowledge. 490.77 An ATURE 490 i6 DATE: ja ®L 490-79 IF 45 APPLICANT TITLE: APPLICANT NAME t s of