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UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN (Page 2of2) <br /> VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING <br /> 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD �41 <br /> 4Q0-54b <br /> 0 I.CONTINUOUS ELECTRONIC MONITORING El 2.FLOAT AND CHAIN ASSEMBLY El 3.ELECTRONIC STAND-ALONE <br /> _04,NO DISPENSERS E99,OTHER(Sp��q�. <br /> . - <br /> 1" --- - <br /> PANE MANUFACTURER MODEL If <br /> 440-56 <br /> -------------------------------------- ------------------ ....... <br /> LEAK SENSOR MANUFACTURER: MODFL <br /> #(S): V0�58_ <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS El a.YES Ob NO 490-59 <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN 0 a.YES 0 b.NO 440-60, <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. [I a.YES []b.NO 440-61 <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. 0 zi.YES Ob NO 440-62 <br /> 2.UDC CONSTRUCTION IS EILSINGLE-WALLED E]2.DOUBLE-WALLED 440,63 <br /> IF DOUBLE WALLED: 490.64a <br /> UDC INTERSTITIAL SPACE IS MONITORED BY: 0 1.LIQUID El 2.PRESSURE 0 3.VACUUM <br /> ------------ ....... ------------____--------- <br /> A LEAK WITHIN THE SECONDARY CONTAINMENTOF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS Ela.YES 0b,NO 4911-641 <br /> VII.PERIODIC SYSTEM TESTING <br /> 0 <br /> I. FLD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65, <br /> LL6 <br /> UST BE PERFORM D. THS AS REQUIRED.(23 K.2ETECTION JEW) —------F __PERIODIC ELD IS PERFORMED EVERY 36 MON <br /> 2,SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490-66 <br /> ®3.SPILL BUCKETS ARE TESTED ANNUALLY. 490-67 <br /> VIII.RECORDKEEPING <br /> The following monitoring/maintenance records are kept for this facility: <br /> 0 Alarm I0gS 490-68a E]Visual Inspection Records 490-68b [I Tank integrity testing results 490-68c <br /> El SIR testing results(and supporting documentation records). 49068d C3 'rank gauging results(and supporting documentation records). 490-68e <br /> ❑ATG Testing results(and supporting documentation records).490-68f E] Corrosion Protection 60-day logs 490-68g <br /> Equipment maintenance and calibration records, 490-69h <br /> IX.TRAINING <br /> Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 00-6% <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) <br /> THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490-69b <br /> OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)4v0-69c <br /> 0 CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-69e <br /> ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND <br /> STATISTICAL INVENTORY RECONCILIATION"490-69f <br /> El SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490-08 <br /> 0 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([CC). <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 LIST systems in a manner consistent with the facility's best management practices <br /> Y 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 /> X. COMMENTS/ADDITIONAL INFORMATION <br /> Provide additional comments here or indicate how many pages with additional inforniation on specific monitoring procedures are attached to this plan.440.71 <br /> North Sump-Tank Gauge-794380-208; Piping Trench Sensor-794380-420 <br /> XI.PERSONNEL RESPONSIBILITIES <br /> The LIST Owner/Operator is responsible for ensuring that: 1)the daily/routine LIST monitoring activities and maintenance of LIST 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 Connie Mitchell 490-72 TITLE EM Site Manager 440-73 <br /> NAME AT&T Environment Health&Safety 440-74 TITLE Call Center 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 ofany <br /> conditions that need follow-up action. <br /> X11.OWNER/OPERATOR SIGNATURE <br /> _ <br /> CERTIFICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. <br /> APPLICANT SIGNATURE -00-7b DATE: 4'x'-77June 11,2008 <br /> UPRF,5EUTIUG W I.Tgi:edomrator0 2 KIIIN�0.­rlojQraml I Aut2nzga RggrgUnt rve f <br /> r <br /> APPLICANT NAME(print): 490-78 APPLICANT TITLE: 49049 <br /> Steven J. Hall Manager, EH&S <br /> U PCF UST-D(12/2007) <br />