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07/10/2009 10:34 2098585066 0 TWO GUYS FOOD 11 UNIMD PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN - jPa e 2 of 2 gVER 6NPEN8Ek-CONTAU0MNT (UJDQ MONITORING UDC MONITORING IS PERFORMED USING THE FOLLOWING METHODS). : I I : Owl IR I - CONTINUOUS ELECTRONIC MONITORING 0 2. FLOAT AND CHAIN ASSEMBLY ❑ .1. ELECTRONIC STANDALONE 49N542, El 4. NO DISPENSERS El 99, OTHER (Specify) 490 -'Ab. LEAK MONITOR MANUFACTURER; JaG 10E& 2= 4-M-S.S. MODEL #: 3 Mansa LEAK SENSOR MANUFACTURER: ILMF!VL A001: 400-57. MODEL W AZZ— '14(150 DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. a. YES Ll b. NO UDC LEAK ALARM TRIGGER -9 AUTOMATIC PUMP SHUTDOWN. a. YES Ij h, NO FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. co 8, YFq b. No 4 UDC MONITORING STOPS THE FLOW FPRODUCT ATTII6 DISPENSER. YF3 ❑ b. NO -FJ6� CONSTRUCTION CTION IS: 0 1. SINGLE WALL RL 2, DOUBLE WALL 1EMUBLE _WALL: 49-CAn. UDC INTERSTITIAL SPACE IS MONITORED BY: 0 a. LIQUID 0 b. PRESSURE ❑ c. VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL AIARMS. El a, YES 3 C3 b. NO 11 - PERIODIC SYSTEM* -TESTING-,.. U 1. ELD TFSTTNGi THIS FACILITY HAS BEEN NOTIFIED By TI TE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED LkK DETECTIONIELM MUST BE PERFORMED. PERIODIC ELDISPERFORMED EVERY 36MONTHS ASnOUIRED.12.iCCR §2r,44.11 2. SECONDARY CONTAINMEN'r COMPONENTS ARE TESTED EVERY 36 MONTHS. 0 3. SPILL BUCKETS ARE TESTED ANNUALLY. 490-r,7. -VW- RECORD KE19PING The following monitarinWmatntanance records are kept lbr this facility: a. ALARM LOGS M b, VISUAL INSPECTION RECORDS (I c. TANK INTEGRITY TESTING RESULTS ❑ d. SIP, TESTING RESIJI.T.3 (and supporting documentation records) 0. TANK GAUGING RESULTS (and supporting documentation records) ❑ f. ATG TESTING RE�91JTXS (and supporting documentation records) Q 9. CORROSION PROTECTION 6NDAY LOGS ED h. EQUIPMENT MAINTENANCE AND CAIJBRATTON RFCORDS DL TRAINING W Pemnnal with UST monitoring responsibilities are familiar with all of the following documents relevant to theirjob duties: 4m� 4s2 REFERENCE DOCUMFNTS MAINTAINED AT FACILITY (Check all that apply) 0 THIS UNDERGROUND STORAGE TANK MONITORING PLAN (Re"trco 490-6% 3 OPFRATING MANUALS FOR ELECTRONIC MONITORING FQUTPMF.NT (Rarlimircd) 440<wo El CALIFORNIA tTNDFRrjROTJNDSTOI;tAGE TANK REGULATIONS 49wivd. Q CALIFORNIA UNDERGROUND STORAGE TANK LAW 49"% ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCR) PUBT.ICATTON: "HANDBOOK FOR TANK OWNFR$ MANUAJ. AND 490-69f STATISTICAL INVENTORY RECONCITTATION- ❑ SWRCB PUBLICATION! 'UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS- 4!0"Cir ❑ 01HER(Spocify): 49N69h. 49"QL- This facility has u"T)csignatcd UST Operator" who has passed Vie California UST System Operator Exam administered by the International Code Council (TCC). The "Designated UST Operator" will train facility employces in the proper operation and maintenance orthe UST systems annually, and within 30 days of hire. This training will include, but is not limited to, the following: )m- Operation or ft UST systems in a manner conaiatent with the fttcil Ity'l; best TrkanagCnmt practices. > The facility employee's role with regard to the monitoring equipment is specified in this UST Monitoring Plan. > The facility ornployce's role with regard to spills and overfills as specified in the facility's UST Response Plan. P- Namo(,q) of contact person(%) for emergencies and monitoring alarms. A .X..C.0)S��-NTS/ADDITIONAL INFORM TION, Provide additional comments here or indicate how many pages with additional information on specific ftwitoring procedures arc attached to this plan. OVE91 FLO Uj P1ZMS-CT1*d f"lECI4h#1CRL,, FL -1 ?MP- SiLT 07 9 XLPERSONNEL RESPONSEBEUMS The UST Owncr/Operator is rcAponsiblc for ensuring that' 1.) the daily/routine UST monitoring activities and maintenance of UST Icak detection equipment covered by this plan occurs; 2.) all conditions that indicate a,posslhle release are invesOp %qd otlitoO records ireyMt d THE FOLLOWING PERSON(S) ARE RESPONSIBLE FOR PERFORMING THUMONrVOKING AND EQUIPMENT MAINTENANCE; NAME: 7A-jLA)ja14 1jL&Qj&pS 400,72. TITLE: OWAIF-f49r - 7a. NAME: &#.er 490-14. TITLE: C. Zt&&ACI-1 The Designated UST Operator shall perform a monthly visual inspection or the fheoity, provide a report to the ownerlopenitor, and inform the owncr/operator of any conditions that need fbllow-ug action XII: OWnR/OPIERATORSIGNATtM*...,...-.. .:,....,. CERTIFICATION: I certify that the Informst on provided herein is true and accurate to the best of to knowleft. APPLICANT SIGNATURE DATE: 491-77 It110 "RWOTM; Tank( "moocrO-1W 49D-76. 49D -7P. APPLICANT NAME (print): [L IV I L- Kj" Bon J n APPLICANT TITLF: 0 440-74. I UPCF UST -V(12/2007)-3/4 www.ouldoesors