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UNIFIED PROGRAM CONSOLIDATED FO <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN (Page 2 of 2) <br /> VI.UNDER DISPENSER CONTAINMENT(V , ONITORING <br /> I. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-540- <br /> 1.CONTINUOUS ELECTRONIC MONITORING ❑2.FLOAT AND CHAIN ASSEMBLY ELECTRONIC STAND-ALONE 490-54b <br /> ❑4.NO DISPENSERS ❑99.OTHER(Specify): <br /> PANEL MANUFACTURER: G87 w x90-55 MODEL#: T!i Cj fi® 490-56. <br /> LEAK SENSOR MANUFACTURER j±j C64,J 490-57 MODEL#(S): 490-59 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS Is a.YES ❑b.NO 490-59 <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN fYa.YES ❑b.NO 490.60. <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. YES ❑b.NO x90.6- <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER a YES ❑b.NO 49x62 <br /> L UDC CONSTRUCTION IS 41.SINGLE-WALLED ❑2.DOUBLE-WALLED 490-63 <br /> IF DOUBLE WALLED: 490-64a <br /> UDC INTERSTITIAL SPACE IS MONITORED BY: 1.LIQUID 2.PRESSURE Q 3.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a YES ❑b.NO 490.64b <br /> VII.PERIODIC SYSTEM TESTING <br /> t. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT E,MANCED 49a-65. <br /> I D MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED. 23 CCR 2644.1 <br /> SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490.66 <br /> 3.SPILL BUCKETS ARE TESTED ANNUALLY. 490667 <br /> VIII.RECORDKEEPING <br /> TIge following monitoring/maintenance records are kept for this facility: <br /> Alarm logs 490194 ❑Visual Inspection Records 490-68b ❑Tank integrity testing results 490 <br /> SIR meting results(and supporting documentation records). 490.M ❑ Tank gauging results(and supporting documentation records). 490.6se <br /> [❑ATG Testing results(and supporting documentation records).490-6sf ❑ Corrosion Protection 60-day logs 490 ag <br /> Equipment maintenance and calibration records. 490166 <br /> UL TRAINING <br /> 10 Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to thea job duties. 49o19a <br /> RENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) <br /> THIS UNDERGROUND STORAGE TANK MONITORING PLAN )490.69b <br /> OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)4go-69c <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 49o-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"49019f <br /> SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"490.696 <br /> OTHER(Specify):M69r4 M69i 'g /IA n(Y W 'Q cT <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 /> A 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 /> A The facility employee's role with regard to spills and overfills as specified-in the UST Response Plan <br /> A Names of contact person(s)for emergencies and monitoring alarms.490.7o <br /> X. COADUNTWADDMONAIL INFO TION <br /> Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan.49x•7 r <br /> OVEQ Foic ®XoTjcr(otJ, o-Pk� 0, a s t�lae�c�.,,f / Int. Vrjpvl-s <br /> M.PERSONNEL RESPONSIBILITTES <br /> The UST Owner/Operator is responsible for ensuring that 1)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 follows on(s) responsible for performing the monitoring and equipment maintenance: <br /> NAME 490-72 TITLE 490-73 <br /> NAME 490-74 TITLE 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 /> XII.OWNERIOPERATOR SIGNATURE <br /> CERTIFICATION:I certify that the information provided herein is true and acxtrve to the best of my knowledge. <br /> APPLICANT SIGNATURE 00, 490.76 DATE: 490-77 <br /> J16--Facility QNS22a= 01AtWWdaWR= <br /> C9 . a - - <br /> APPLICANT NAME(print): 490"76 APPLICANT TITLE: 490-79 <br /> UPCF UST-D(12/2007)3/4 <br />