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09/22/2003 12:24 209dE50723 TOYS R US DC 58 PAGE 01/08 , , -.0 Fax Transmittal Memo No. piaagea M, Thne �, l A,,A A ZA7k From �� +' �- Company � " ' ' " /W' Company'y Location .. .�1 �. US / Location Dapt. Charge Cpmmen[5 Fax N 1§laphonc N Fax #' � 7aC.C,r Lv_ . Telephone N Original . Disposition: ❑Deatrcy pRetum Call for Pickup SAN JOAQUI N COUNTY ENVIRONMENTAL HEALTH DEPARTMENT UNDERGROUND STORAGE TANK MONITORING PLAN - PAGE 1 TYPE OF ACTION ❑ L NEW PLAN [fir 2. CHANGE OF INFORMATION Mo. PLAN TYPE ❑ MONITORING IS IDENTICAL FOR ALL USTS AT THIS FACILITY. (Check ane item only) THIS PLAN COVERS ONLY �FOLLOWING UST SYSTEM(Sy -S /r/Ml- FACILITYOnly) Ma iD # A enr. � Use Cn 3 A 7< `I�JrAA�N FACILITY NAME W) Moa. At".1LITY SITE ADDRESS 77 C , f04' CITY Ii-EQUIPMENT,TEs i1vG ANb I►RE N� X' E MA XNTENANCE State law requires that testing ptevennve mainan tence and calibration of monitoring equiprncnt (e,g., sensors, robes, line leak detectors, etc, be accordance With the equipmcttt manufacturers' instructions, or annually, whichever is more frequent, Such work must be performed by qualified personnel. omned to ' MONITORING EQUIPMENT IS SERv7CED �. ANNUALLY Q 99.OTRER (Specify): Mo?. 8 yatcmetc.). � (S ng ..p (' :IiL. Mb RiN,(yrLOCA�'LONS. This monitoring plan must include a Site Plan shovnng the general tank and t trig layouts and the locations where monitoring ea crformed t.c., tocauon ofeach flcnsor, line leak detector, monitoring s control panel etc ). If you Alread have a diagram e.., current UST Monitoring Site Plan from a Monitoring System Certification Hazardous Materials, Business Plan Irrap. etc.) which shows all required information, include it with this plan. - ' I"V ,�raNt�-rizoNrira�c- .. MONITORING IS PERFOF-MED USING THE FOLLOWING METHOD(S): (Check all that apply) Mlo. ❑ 1, CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR (rNTERSTMAL) SPACE(S) OR SECONDARY CONTAINMENT VAULT(S) SECONDARY CONTAINMENT 1S: W -a DRY ❑ b. LiQUiD FiLLED ❑ C. UNDER PRESSUIRE ❑ d. VACUUM Mi 1. PANEL MANUFACTURER M[t• MODEL.. e/2 -S - -Y5 a Mtn. LEAK SENSOR MANUFACTURER FF10 TvzoJi Mu. MODEL#(S): -/LTG S yy MIs. ❑ 2. AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SINGLE_ WALL T&�%C % PANEL MANUFACTURER: MI6. MODELq;yy Mn. N -TANK PROBE MANUFACTURER MIs, MODEL#(J): M19. LEAK TEST FREQUENCY: ❑ &-CONTINUOUS ❑ b. DAILYINIGHTLY ❑ C. WEEKLY M20. ❑ d. MONTHLY ❑ e. OTHER (Specify): Mei. PROGRAMMED TESTS: L3 2- 0.1 g.p.h. ❑ b. 0.2 g.p.h, ❑ c. OTHER (Specify): W2 M23. C13. INVENTORY RECONCILIATION ❑ a, MANUAL PER 23 CCR §2646 ❑ b. STATISTICAL PER 23 CCR §2646,1 M24. ❑ 4. WEEKLY MANUAL TANK GAUGING (MTG) PER 23 CCR §2645 TESTING PERIOb: ❑ a, 36 HOURS ❑ b. 60 HOURS M25. ❑ 5, INTEGRITY TESTING PER 23 CCR §2643.1 TEST FREQUENCY: Lr7 a. ANNUALLY ❑ b. BIENNIALLY ❑ c, OTHER (Specify): M26 M27. ❑ &ViSUAL MONITORING DONi:: [vj'a. DAiLY ❑ b. WEEKLY (xequtm naeneyapp nit) ❑ 99. OTHER (Specify): h12fl, V. PIPE :lYIONITbRIiG MONITORING iS PERFORMED USING THE FOLLOWING METHODS) (Check all that apply) Mao. ❑ I. CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(Sy rRENCH(ES) AND OTHER SECONDARY CONTAINMENT SECONDARY CONTAINMENT iS: &rs. DRY ❑ b, LiQUiD FILLED ❑ C. UNDER PRESSURE d. UNDER>VACUUM MI I. PANEL MANUFACTURER: r Mae, MODEL #: ✓'�r�.S "JSI� M.U. LEAK SENSOR MANUFACTURE�nICgsC Ma+. MODEL #(S): Y fZ J I- - M35. WILL A PiPING LEAK ALARM TRIGGER AUTOMATIC PUMP (i.e.. TURBINE) SHUTDOWN? [rj' a. YES ❑ b. NO MI6. WILL FAILUREJDISCONNECTiON OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑" AYES J(D ❑ b.NOMal. 2. MECHANICAL LiNE LEAK'DETECTOR (MLLD) THAT ROUTINELY PERFORMS 3.0 g,p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK iSEC MLLD MANUFACTURER(&): MODEL#(S): - MA ❑ 3. ELECTRONIC LiNE LEAK DETECTOR (ELLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS ELLD MANUFACTURER: Moo, MODEL #: Mot. PROGRAMMED LINE INTEGRITY TESTS: Q a. MINIMUM MONTHLY 0.2 g.p.h. ❑ b. MINIMUM ANNU L 0.l g.p.h. Na MAXWILL ELLD DETECTION OF A PIPING TRIGGER AUTOMATIC PUMP SHUTDOWN? YES ❑ b, NO M43, WiLL ELLD FAILUPEIDiSCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? a, YI S ❑ b. NO Mod' ❑ 4. INTEGRITY TESTING TEST FREQUENCY: Ora. ANNUALLY ❑ b. EVERY 3 YEARS ❑ c. OTHER (Specify) Mot, M46. ❑ 5.VISUAL MONITORING DONE: ["a, DAILY ❑ b. WEEKLY" ❑ e. MIN, MONTHLY & EACH TIME SYSTEM OPERATED*e M47. • RegW- aacaey 29-011 •' Allowed for menit«Ina oruwuaed en,eraenry arxratmatel pWpinfl ooh l_ ttSC §153a1_s(yN3) ❑ 6. PIPING iS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXEMPTION FROM MONITORING PER 23 CCR §2636(a)(3) ❑ 7. NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) ❑ 99. OTHER (Specify) Mos. SJCEM" (07/03) -1/4 07123103