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HomeMy WebLinkAbout215 21ST ST IIIIIII VIII III IIII 59 06130110 WED 11:01 FAX 0616351184 PEPSI BAKERSFIELD WRHS 1E 1�j002 15-021-000984, PEPSI COLA BOTTLING GROUP 954, 6/30/2010 10:37:40 AM UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN-(Page 1 of 2) TYPE 0;rAC;nO1N ❑ L NEW PLAN 10 2.CHANGE OF INFORMATION 490-1. PLAN TYPE 1,MONITORING IS IDENTICAL FOR ALL USTS AT THIS FACILITY. 490-2.1 (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): 2 FACILITY ID#(Agency We Only) 11 15 '-P�:N,10 10 10 19 0 14 M BUSINESS NAME(Same as Facility Name orDBA) PEPSI COLA BOTTLING GROUP 954 BUSINESS SITE ADDRESS 103• CITY 104. 215 E 21ST ST BAKERSFIELD -6 To5brip,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must be performed at the frequency specified bythee9tripmentm manufacturers'instructions,or annually.whichever is more frequent Such work must be performed bv ficdpeE-nS1,2jC- :�t32.1634.263!,1641_ . 490-3. MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY ❑ 99.OTHER(Specify): 490�3b. -`4 9 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN ❑ 2.SrM PLOT PLAN/MAP PREVIOUSLY SUBMITTED 123 CCR 42632,26341 49104• 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) 490.5. WITH AUDIBLE AND VISUAL ALARMS.123 CCR 12632.26341 SECONDARY CONTAINMENT IS: 0 a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 490-6 PANEL MANUFACTURER Veeder Root 490-7. MODEL#: TLS-35OR 404 LEAK SENSOR MANUFACTURER: Veeder Root 490-9• MODEL#(s): 794380-352 490-10• ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR S21 LE WALL TANK(S.l23 ccR 12643i 490-11. PANEL MANUFACTURER-- 490-12• MODEL#: 490-13. IN-TANK PROBE MANUFACTURER. 490-14• MODEL#(S): 490-15. LEAK TEST FREQUENCY: ❑ &CONTINUOUS ❑ b.DAILYMIGHTLY ❑ c.WEEKLY 490-16• ❑ d.MONTHLY ❑ c.OTHER(Specify): 490-17- 4 PROGRAMMED TEST& 0.1&p h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): 490,19,90-14. ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION[23 CCR J2646 L] 1990-25. ❑ 4,WEEKLY MANUAL TANK GAUGING(MTG)M ccR ozwj TESTING PERIOD: ❑ iL 36 HOURS 0 b.6014OURS 490-21, 490-22, ❑ 5.TANK RfMORITY TESTING PER 123 CCR V.643.iI 490-23. 90-V, TEST FREQUENCY: ❑ a.ANNUALLY [] b,BIENNIALLY ❑ Q OTHER(Specify): 1 423 16. 4W [1 99.OTHER�Specify): 490%-27. err..WNX-NrWEIN�!';' *,w v -w- wt;A.-W- V I, 1.CONTINUOUS MONITORING OF PHUPIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 490-28• cc" SECONDARY CONTAINMENT IS: ❑ a.DRY ❑ b,LIQUID FILLED ❑ c.PRESSURIZED ❑ d,UNDER VACUUM 490.2- CA PANEL MANUFACTURER: Veader Root 490-30• MODEL#: TLS-35OR 4W31• LEAK SENSOR MANUFACTURER: Veeder Root 4"-32. MODEL#(S): 794380-352 490.33. PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. 99 a.YES ❑ b.No 490-14• FAILURE(DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. 9] a.YES ❑ b.NO 49D-35, ❑ 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0&pA LEAK TESTS AND RESTRICTS OR SHUTS OFF 49 PRODUCT FLOW WHEN A LEAK IS DETECTED.(23 C0.126361 MLLD MANUFACTURER(S): 49047. MODEL tS): 490-39. ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0&p.h.LEAK TESTS.[23 CCRJ28361 *90.39' ELLD MANUFACTURER(S); 490-40. MODEL#(S): 490-01. PROGRAMMED IN LINE LEAK TEST; ❑ a MINIMUM MONTHLY 0.2g.p.h. 0b.MINIMUM ANNUAL 0.1g.p.h. 490.42, ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 490-43• ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. YES ❑ b.No 490-44• ❑ 4.PIPE INTEGRITY TESTING. TEST FREQUENCY: ANNUALLY. b,EVERY 3)TARS ❑ c.OTHERS ifd 490-46. ❑ 5.VISUAL PIPE MONITORING. 49041. FREQUENCY: DAILY b.WEEKLY ❑ U.MN.MONTHLY&EACH TIME SYSTEM OPERATED* 49049. Allowed for mmdw*mof wbadad @m rmncy SnEpM fW1 P01M wly per HSC 1) L210-L5DX- 6.SUCTION PIPING MEETS EXEMPTION CRITERIA.123 ccR 42636(wm 49�Td'- ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM, 49D-51:" ❑ 99.OTHER(Speci5j, 49413. UPCF UST-D(12/2007)-V4 www.unidocs.org IIIIIIIIIIIIIIIIIIII 60 IE 06/30/10 WED 11:03 FAX 6616351184 PEPSI BAKERSFIELD WRHS IM003 UPCF UST Monitoring Plan -Page I Instructions Complete a separate UST Monitoring Plan for each UST monitoring system at the facility. This form must he submitted with your initial UST Operating Permit Application and within 30 days of changes in the information it contains. Your local agency may require you to obtain approval prior to installing or modifying monitoring equipment (Note: Numbering of these instructions follows the data element numbers on the form.) 490-1. TYPE OF ACTION-Check the appropriate box to indicate why this plan is being submitted. 490-2. PLAN TYPE-Check the appropriate box to indicate whether this plan covers all,or merely some,of the USTs at the facility. If the plan covers only some of the tanks,identify those tanks in the space provided(e.g.,by using the Tank ID#(s)in item 432 of the UST Operating Permit Application-Tank Information Form(s)]. 1. FACILITY ID NUMBER-Ibis space is for agency use only. 3. BUSINESS NAME-Enter the complete Facility Name. 103. BUSINESS SITE ADDRESS-Enter the street address where the facility is located,including building number,if applicable.Post office box numbers are not acceptable. This information must provide a means to locate the facility geographically. 104. CITY-Enter the city or unincorporated area in which the facility is located. 490-3a. MONITORING EQUIPMENT IS SERVICED-Check rite appropriate box to specify the frequency of monitoring equipment testing/certification. 490-3b. Specify Other frequency for monitoring equipment servicing. 490-4. SITE PLAN-Indicate if a site plantmap is submitted with this monitoring plan or if it was submitted previously and is current for the facility. Monitoring plans must include a Site plot Plan/Map showing the tank and piping layouts and the locations where monitoring is performed(i.e.,location of sensors, probes,line teak detectors,monitoring system control panel,etc.). 490-5. TVA CONTINUOUS ELECTRONIC MONITORING-Indicate if this monitoring method is being used to monitor the tanks. 490-6. SECONDARY CONTAINMENT-If IV-1 is checked,check the appropriate boot to describe the environment inside the tank secondary containment. 490-7. PANEL MANUFACTURER-If IV-1 is checked,enter the name of the manufacturer of the monitoring system control panel(console).. 4904. MODEL#-If IV-1 is checked,enter the model number for the monitoring system control panel. 490-9. LEAK SENSOR MANUFACTURER-If IV-1 is checked,enter the name of the manufacturer of the sensor(s).If additional space is needed,use Section X. 490-10. MODEL AS)-If IV-I is checked,enter the model number for each type of sensor installed.If additional space is needed,use Section X. 490-11. IV-2 AUTOMATIC TANK GAUGING-Indicate if this method is used fbr monitoring the UST's. 490-12. PANEL MANUFACTURER-If 1V-2 is checked,enter the name of the manufacturer of the monitoring system control panel(console). 490-13. MODEL#-If IV-2 is checked,enter the model number for the monitoring syslem control panel. 490-14. IN-TANK PROBE MANUFACTURER-If N-2 is checked,enter the name of the manufacturer of the probe(s). 490-15. MODEL#(S)-If IV-2 is checked,enter the model number for each type of In-tank probe installed.if additional space is needed,use Section X. 490-16. LEAK TEST FREQUENCY-If IV-2 is checked,check the appropriate box to describe the in-tank leak test frequency. 490-17. SPECIFY-If 490-16e is checked,enter the frequency of programmed leak tests. 49D-18. PROGRAMMED TESTS-If IV-2 is checked,check the appropriate box to describe the tests programmed into the ATO system. 490.19. SPECIFY-If 490-)Sc is checked,enterthe frequency of in-tank leak testing. 490.20. IV-3 INVENTORY RECONCILIATION-Check the box if statistical inventory reconciliation is performed. 490-21. IV-4 WEEKLY MANUAL TANK GAUGING,Indicate if this method is used to monitor the tanks. 49D-22. TESTING PERIOD-If IV-4 is checked,check the appropriate box to describe the MTG testing period. 490-23. IV-5 TANK INTEGRITY TESTING:Indicate if this method is used to monitor the tanks. 490-24. TEST FREQUENCY-IfIV-5 is checked,check the appropriate box to describe the frequency of tank integrity testing. 490-25. OTHER:If 490-24c is checked,specify other test frequency. 490-26. IV-99 OTHER:Indicate if monitoring of the tanks occurs that is not indicated in arry other category. 490-27. If IV-99 is checked,enter a brief description of the other tank monitoring method(s)used(e.g.,vadose zone monitoring per 23 CCR§2647,groundwater monitoring per 23CCR§2646). Include the monitoring frequency(e.g.,Continuous,Weekly). If additional space is needed,use Section X. 490-28, V-1 CONTINUOUS MONITORING OF PIPE/PTPING SUMP(S) AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND VISUAL ALARMS:Indicate if this is the monitoring method used for the piping. 490-29. SECONDARY CONTAINMENT:If V-1 is checked,Check the appropriate box to describe the environment inside piping secondary containment 490.30. PANEL MANUFACTURER-If V-1 is checked,enter the name of the manufacturer of the monitoring system control panel(console). 490-31. MODEL#-If V-1 is checked,enter the model number for the monitoring system control panel- 490-32. LEAK SENSOR MANUFACTURER-If V-1 is checked,enter the name of the manufacturer of the sensot(s). 490-33. MODEL#(S)-If V-I is checked,enter the model number for each type of sensor installed.If additional space is needed,use Section X. 490-34. PIPING LEAK ALARM T RIGGERS AUTOMATIC PUMP SHUTDOWN -If V-I is checked,check Yes or No. 490-35. FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN-IfV-I is checked,check Yes or No. 490.36. V-2 PIPE MECHANICAL LINE LEAK DETECTORS PERFORM 3 GPH LEAK TESTS:Indicate if this monitoring method is used to monitor the pipelines. 490-37. MLLD MANUFACTURER(S)-If V-2 is checked,enter the names)of the manufacturer(s)of the mechanical line leak dctector(s).If additionsi space is needed,use Section X. 490-38. MODEL#(s)-If V-2 is checked,Enter the model number for each type of mechanical line leak detector installed.If additional space is needed,use Section X. 490-39. V-3 PIPE ELECTRONIC LINE LEAK DETECTORS:Indicate if this monitoring method is used to monitor the pipelines. 490-40. ELLD MANUFACTURER-I£V-3 is checked,Enter the name of the manufacturer of the electronic line leak detector(s). 490-41. MODEL#(S)-If V-3 is checked,enter the model number for each type of electronic line leak detector installed.If additional space Is needed,use Section X. 490-42, PROGRAMMED LINE INTEGRITY TESTS-if V-3 is checked,check the appropriate box to describe the type of tests programmed into the monitoring system, 490-43. ELLD DETECTION OF A PIPING LEAK ALARM TRIGGERS PUMP SHUTDOWN-IfV-1 is checked,check Yes or No. 490114, ELLD DETECTION OF A PIPING LEAK FAILUREIDISCONNECTION TRIGGERS PUMP SHUTDOWN-If VA is checked,check Yes or No. 490115. V4 PIPE INTEGRITY TESTING-Indicate if this monitoring method is used to monitor the pipelines. 49D 46. TEST FREQUENCY-If V-4 is checked,check the appropriate box to describe the frequency of pipe integrity testing. 49047. SPECIFY-If 490-46-99 is checked,enter the frequency of pipe integrity testing. 490-48. V-5 VISUAL PIPE MONITORING-Indicate if this monitoring method is used to monitor the pipelines. 490-49. If V-5 is checked,check the appropriate box to describe the frequency of visual monitoring. 49D-5D. SUCTION PIPING MEETS EXEMPTION CRITERIA- Indicate if this monitoring method is used to monitor the pipelines. 490-51. NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM- Check this box if no piping in the tank system is regulated under the UST law,or there is no piping. 490-52. V-99 OTHER-Indicate if another method is used for pipeline monitoring. 490-53. SPECIFY-Enter a brief description of the other line monitoring method(s)used. If additional space is needed,see Section X. Be sure to clearly describe monitoring method(s)and frequency. This monitoring plan must include a Site Plan showing the general tank and piping layouts and the locutions where monitoring is performed(i.e.,location of each sensor,line leak detector,monitoring system control panel,etc.). If you already have a diagram(e.g.,current UST Monitoring Site Plan from a Monitoring System Certification tb'm,Hazardous Materials Business Plan map,etc.)that shows all required information,include it with this plan. UPCF UST-ID(12/2007)-2/4 www.uoidemarg 06/30/10 WED 11:04 FAX 8816351184 PEPSI BAKERSFIELD WRHS Z004 UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN--(Page 2 of 2 ko UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) ❑ 1.CONTINUOUS ELECTRONIC MONITORING El 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 490654L ❑ 4.NO DISPENSERS ❑ 99.OTHER S 490-546. _ ( �nfy) LEAK MONITOR MANUFACTURER: 490-55' MODEL#: 490-56. LEAK SENSOR MANUFACTURER: 49037. MODEL#(S): 490.55. DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. ❑ a.YES [x] b.NO 490-59. UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ® b.NO 411- . FAILUREMISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ e_YES ® b.NO 49061. UPC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. _ _© a.YES ❑ b.NO 491.61. I 490.0. I` UDC CONSTRUCTION 15: ® I.SINGLE WALL ❑ 2.DOUBLE WALL IF DOUBLE WALL: 4"44L UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ a.LIQUID ❑ b.PRESSURE ❑ c.VACUUM A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. ❑ a.YES ❑ b.NO 4"44b. :c•.r. 4--...._: rir r.�..._.,,._ :I °,ti ..: ._.�... S.J31 .-.D1 C7' { N I i 1 r,rl..s+.,vpr"t4-�''�x 4 F'ijr . © 1.ELD T ESTING:THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 4911-65• EAK ON MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED.123 CCR 644.1 © 2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490.66• ® 3.SPILL BUCKETS ARE TESTED ANNUALLY. 49 7. The following monitoring/maintenance records are kept for this facility: 490-68• E] e.ALARM LOGS ® b.VISUAL INSPECTION RECORDS ® c.TANK INTEGRITY TESTING RESULTS ® d.SIR TESTING RESULTS(and supporting documentation records) ❑ e.TANK GAUGING RESULTS(and supporting documentation records) ® f.ATG TESTING RESULTS(and supporting documentation records) ❑ g CORROSION PROTECTION 60-DAY LOGS ® It EQUIPMENT MAINTENANCE AND CALIBRATION RECORDS El',_•' ` {r- a 7t•" .A - ..t,-�- I, - _ 'q....�,, ��,� 1 �u �;:.,:�:• ;'r;�`,��...fi5��-r:•S::'k�yncl:ii]�.Is:iz; .,..c� r r5L '"•r. Ua+}vmnt, ,.:F.„ .F. y.T_,f;IT,� r';. ,...'r.. .,,_. _r:.-0-1',.:6 ..�ec^ed.° _ n•b�=v Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties: 490.69& REFERENCE DOCUMENTS MAINTAINED AT FACII.MO(Check aff that apply) ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 490-69b. ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Repaired) 490-69c. ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d. ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 49D-690- ❑STATE W ATER R ESOURCES C ONTROL B CARD( SWRCB)P UBLICATION:"HANDBOOK FOR T ANK 0 WNERS - MANUAL A ND 490-W STATISTICAL INVENTORY RECONCILIATION" ❑SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 49M9r, ❑ OTHER(Specify): 490.691L 490-W This facility has a"Designated UST Operator'who has passed the California UST System Operator Exam administered by the Intematioruil Code Council 49D-70. (ICC). 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 training will include,but is not limited to,the following: ➢ Operation of the UST systems in a manner consistent with the facility's best management practices. ➢ The facility employee's role with regard to the monitoring equipment as specified in this UST Monitoring Plan. ➢ The facility employee's rote with regard to spills and overfills as specified in the facility's UST Response Plan. ➢ Name(s)of contact person(s)for emergencies and monitoring alarms. C: +--.:tYu�� f ,-><( ,r .J 1e wf -01-40* 1 �" fl v rly l r.y Provide additional comments here or indicate how marry pages with additional information on specific monitoring procedures are attached to this plan. 490.71. ,n.0 - 4 1 'ri 1 I ., '•�-�F, � 1L1pJJ:i- �it � '�`�- li! °-.{� _ 1�, .I�' 'cg�y1PS ,�-'! 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 this phm occurs 2. all conditions that indicate a possible release are investigated;and 3.)all monitoring records are maintained properly. THE FOLLOWING PERSON(S)ARE RESPONSIBLE FOR PERFORMING THE MONITORING AND EQUIPMENT MAINTENANCE: NAME: 49Q72 TITLE: 490-73, NAME: 490.74. TITLE: 490-75. { The Designated UST Operator Shall perform a montbly visual inspection of the facility,provide a report to the owner/operator,and inform the owner/operator of any conditions that need to]ow-up action q y _ I ,... ..,.x. 1..rN. � :7.trf. �...:crc CERTIFICATION:I certl that the information provided herein is true and accurate to the best of my knowledge, APPLICANT SIGNATURE DATE: 490-77 RePRWENnNo-. t.Tu&oo er ac� 0wmrr W„6r z.Athmi=,d r.M,6woro, r 490-76. 2010/03/03 APPLICANT NAME(print): 490.76' APPLICANT TrrLE: 490-79. Casey Blair Product Availabiltiy Manager UPCF UST-D(12/2007)-314 www.unidoes.org 06/30/10 WED 11:05 FAX 8816351184 PEPSI BAKERSFIELD WRHS X1005 (Agency Use Onty) This plan has been reviewed end: ❑Approved ❑Approved With Conditions ❑Disapproved Local Agency Signature: pate: Comments or Special Conditions: UPCF UST Monitoring Plan—Page 2 Instructions Complete a separate UST Monitoring Plan for each UST monitoring system at the facility. This form must be submitted with your initial UST Operating Permit Application and within 30 days of changes in the.information it contains. Please note that your local agency may require you to obtain approval prior to installing or modifying monitoring equipment. (Note: Numbering of these instructions follows the data element numbers on the form.) 490-54s.MONITORING OF THE UNDER DISPENSER CONTAINMENT—Indicate the method used for UDC monitoring. 490-54b,SPECIFY—If 99"Other"is checked,describe other method used If Vl-1-1,VI-1-2 or VI-1-3 or VI-1-99 is checked,complete 490.53 to 490-64b. 490-55. PANEL MANUFACTURER—Enter the tame of the manufacturer of the monitoring system control panel(carsole). If there is no control panel(e.g.,only on electrical relay box is installed)leave this space blank 490-56. MODEL 4—Enter the model number for the monitoring system control panel(console}If them is no control panel(e g.,only an electrical relay box is installed)leave this space blank .49D-57. LEAK SENSOR MANUFACTURER—Enter the name of the r anufacturer of the sensor(s). 490-58. MODEL ii(S)-Enter the model number of the scawr(s)Installed.If additional space is needed,use Section X. 490-59. DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. Indicate Yes or No. 490-60. UDC LEAK ALARM TRIGGERS PUMP SHUTDOWN—tndicate Yes or No. 490.61. FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN—Indicate Yes or No. 490-62. UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER—Indicate Yes or No. 490-63. UDC CONSTRUCTION—Indicate if the construction of the UDC is singlo•walled,or double-walled. 490-64a.DOUBLE-WALLED INTERSTITIAL SPACE MONITORING—Indicate what is used to monitor the Interstitial space. 49D-64b.LEAK WITHIN THE SECONDARY CONTAINMENT OF UDC TRIGGERS AUDIBLE AND VISUAL ALARMS—Indicate Yes or No. 490-65, V1I-1 II,D TESTING—Check the box if you have been notified by the State Water Resources Control Board(SWRCB)that the UST(s)covered by this plan Ware subject to Enhanced Leak Detection Requirements(i.e.,UST has any singlo•wall component and is located within 1,000 feet of a public drinking water well). 490-66. TESTING OF SECONDARY CONTAINMENT COMPONENTS EMY 36 MONTHS—Check the box if you have secondary containment that requires testing. 490.67. SPILL BUCKET TESTING—Check the box if you have spill buckets. 490-6B, VIII RECORDKEEPING—Indicate which toonitoring and equipment maintenance records are maintained for this facility. 490-69a IX TRAINING STATEMENT—Check the box to verify that the statement is true. REFERENCE DOCUMENTS MAINTAINED AT FACILITY—Cbeck the appropriate boxes to describe reference documents maintained at the facility. Note that the first two items on the list MW be kept at the facility. 490-696.MONITORING PLAN:Indicate that this plan is kept as a reference document. 490-690.OPERATING MANUALS FOR ELECTRONIC EQUIPMENT:Indicate that this plan is kept as a reference document 490-69d.CA UST REGULATIONS—Indicate that this is kept as a reference document. 490-69m,CA UST LAW—Indicate that this is kept as a reference document. 490-69f. STATE WATER RESOURCES CONTROL BOARD(SWRCB)PUBLICA77ON— "13ANDBOOK FOR TANK OWNERS—MANUAL AND STATISTICAL INVENTORY RECONCILIATION":Indicate that this is kept as a reference document 490-698.S WRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS":Indicalc that this is kept as a reference document. 490-69h.OTHER—Indicate that other reference documents are kept 490691. SPECIFY—If'OTHER"is chocked,enter a brief description of the other document(s)maintained at the facility.If additional space is needed,see Section X 490.70, DESIGNATED OPERATOR TRANNING—Check this box to verity that this statement is true. 490-71. COMMENTSIADDITIONAL INFORMATION—Make additional comments or you may attach and identify the number of additional pages of bZ0110ation to describe any additional UST system monitoring-related information(e.g.,additional information required by your local agcney) Attach any monitoring logs that you will be using for the monitoring of your tank system 49072. NAME—Enter the none of the person who routinely conducts the monitoring and equipment maintenance under this plan 490-73. TITLE—Enter the title orthe person. 490-74. NAME—Enter the name ofthe second person,if applicable,who routinely conducts the monitoring and equipment maintenance under this plan. 490-75. TITLE—Enter the title of the second person OWNER/OPERATOR SIGNATURE—The tank ownedoperator,faality owner/operator,or an authorized representative of the owner shall sign in the space provided. This signature eerti6es that the signer believes that all information submitted is true,accurate,and eomple/e,and that the training program specified in Section IX has been implemented. 490-76. REPRESENTING —Check the appropriate box to indicate whether the signer is the UST owmnropemor, the UST facility owner/operator, or an suthorizod ropresentative of the mine. 490-77. DATE—Enter the date the plan was signed 490-78. APPLICANT NAME—Print or type the name of the person signing the plan. 49079. APPLICANT TITLE—Enter the title of the person signing the plan. UPCF UST-D(1212007)-4/4 www.unidets.org 06/30/10 WED 11:01 FAX 6616351184 PEPSI BAKERSFIELD WRHS Z 0 O 1 i' 215 EAST 21 ST STREET BAKERSFIELD,CA 93305 66-1-635-11881635-1138 TOTAL NUMBER OF PAGES DATE: _L11, %- TO:- �4NI,�E zl;lx�')/ COMPANY 42�Z 1 FAX NUMBER FROM: WAREHOUSE DEPARTMENT FAX NUMBER(661) 635-1184 REMARKS: onf i I)/Le'v, l��(