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11/20/2006 12:44 2094650723 TOYS R US DC 58 PAGE 02/05
<br />SAN JOAQUiN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
<br />UNDERGROUND STORAGE TANK
<br />MONITORING PLAN - PAGE 1
<br />TYPE OF ACTION ❑ I , NF,W PLAN U-1, CHANGE OF INFORMATION
<br />PLAN TYPEMol,
<br />0 MONITORING 15 IDENTICAL FOR ALL USTs ATTk[IS FAC.1L[TY`
<br />(Check one item only) U7141S PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(Sy 7i/e,yce— r—UIfL �j j p ^02
<br />.A�cr1L,tTY zrolrilA'IN
<br />FACiLITY ID lI (AgenCy Use Only)
<br />-�'°�''' 7
<br />FACILITY NAME
<br />76 f �1
<br />/� `Mns.
<br />FACILITY SiTF, ADDRESS G y /ole
<br />Moa CITY
<br />U. EQUIP,NiE1NI' TSS ING AND PREV-.N'I'NE, M.Ai1�T'Y'ENAi�?lC
<br />- E � 5.
<br />Slate law requires that testisgr P
<br />reventivc mllntenanCe, and calibration of monitoring cquipmcnt (e.g., sensors, probes, line leak detectors, etc,) be PerfOrmet3 in Mos
<br />accordance with the cquipmcnt minufacttirers' mgtnictiona, or annually, w)tiehcv(r is more frequent. Such work rnust be perrormcd by qualified persomncl.
<br />MONITORING EQUIPMENT iS SERVICED �. ANNUALLY ❑ 99, OTHER (Specify): Mol.
<br />I-11io IrronnOnng plan must Inc. 1C�[1�T�rCbRNG X�CiCTI+ONS.
<br />Th
<br />lyse n Sitc Plan ;hwingthe gcneIf
<br />tank end e a din layouts and the locations where monitoring 1a pc4ormed (i.e„ locatinm of cath Sensor,
<br />lint leak detector, monitoring system control panel, etc,). If you already have o dilgram (e.g., current UST Monitoring Site Plan from a Monitoring System Certification
<br />form Ha pydouc Materials Ausincss Plan ma cte.) which show�sT111 required iinnfonrmatioon include
<br />�it�wiiel this plan,
<br />-- �'. TANK G. ._.
<br />M ITOR. - ..
<br />TNG IS PERFORMED USiNG TI•IL- FOLLOWING METHOD(S); (Check 11l that ;tpply)
<br />Mio,
<br />i, CONTINUOUS ELECTRONIC MONITORING SF TANK ANNULAR UNTERSTITIA1.,) SPACE(S) OR SECONDARY CONTAINMENT VAULTS)
<br />SECONDARY CONTAINMENT IS; Era. DRY b, LIQUID FILL
<br />���." "� ED ©C. UNDER PRF.SSURF_ [Id, UNDER VACUUM 14". MANUFACTURER: v�Gr«wrr�pp M12. MODEL g: %z S
<br />3o Mt,.
<br />i.EAK SENSOR MANUFACTURER; V R,+►.uo r- M
<br />[] 2, AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SIN Ai T ' S - _ 79 • _. T rets, z/z+
<br />PANFT, MANUFACTURER; GLE'�"r"AN14 ) MODEL #1{S)
<br />Mtc. MODEL lQ Miv,
<br />iN-TANK PROBE MANUI,ACTURL'R: MIN. MOnEL #(s): Mt?.
<br />LEAK TEST FREQUENCY; ❑ a, CONTINUOUS
<br />❑ b. DATLYlNTGfITLY ❑ c. WEEKLY Mto.
<br />❑ d. MONTTILY ❑ c, OTHER (Specify); M21.
<br />PROGRAMMED TEST& ❑ a. 0.1 9.p. h. ❑ b. 0.2 g,p.h. Q C. OTHER (Spcci(y): M21 Mai.
<br />[j 3. INVENTORY RECONCILIATION ❑ a. MANUAT, PLR 23 CCR §2646 ❑ b. STATISTICAL PER 23 CCR §2646.1
<br />M2J.
<br />❑ 4. WEi3KLY MANUAL TANK GAUGING (MTG) PER 23 CCR §2645
<br />TESTING PERIOD: ❑ a. 36 HOURS Q b. 60 HOURS M2-9.
<br />❑ 5. INTEGRITY TESTING PER 23 CCIrk2643.1
<br />TESTFRFQUENCY; y, ANNUALLY ❑ b. BTENNIALLY [] c. OTi-IER (Specify): Mgt. M27.
<br />❑ 6. VISUAL MONITORING DONE: _ - o DAiLY ❑ b. WlrEKLY (Requires agency nppro�nq
<br />❑
<br />99. OTHER (Specify):
<br />Mae.
<br />v. PIp'C MONITORING
<br />MU1ITORING IS PERFORMED TISiNG THF FOLLOWING MFTITOD(S) (Check all that apply) Mao,
<br />�F I • CONTINUOUS ELECTRONIC MONITORING OF PiPING SUMP(S)ITRLNCH(US) AND OTHER SECONDARY CONTAINMENT
<br />SECONDARY CONTAINMENT- is; DRY ❑ b. LIQUID FILLET) ❑ c. i.INDLIZ PRF4SURF d, UNDER VACUUM Mil
<br />PANELMANUFACTURER: !/�Dr Mit. MODELS; I/- X7'1-S- 5_0 M33,
<br />LEAK SENSOR MANUFACTURFR: M74 MODEL H(S) — _ d Mas ag
<br />WiLL A PiPiNG LEAK ALARM TRIGGER AUTOMATIC PUMP (i.e., TLiRI3TNE) SHUTDOWN? ,�,� M.rR,
<br />WILL FAII_UREfDISCONNFCTTON OF THF MONITORING SYS7TM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a YES �� b. NO
<br />Ll 2, MECHANICAL LINE LEAK DETECTOR (MLT,D) THAT ROI TTINET,Y PERFORMS 3 0 El a, YES bNO Mal.
<br />PRODUCT FLOW WHEN A LEAK IS DETFjCTFD— _' g.p.h. LEAK TESTS AND RFSTPIC_TS OR SHUTS OFF
<br />MLLD MANUPACTITRER(s); —�7M38
<br />❑ 3. ELECTRONIC LINT LEAK DETECTOR (ELLD) THAT ROUTINELY PFRroRMS 3,0 g.p.h. f,EAK TESTS —`
<br />Ei,LD MANUFAC71 IRER: _ Meo. MODEL #:
<br />PROGRAMMED LiNF. iNTL(iRITY TESTS: [] a. MINIMUM MONTTILY 0,2 g.p.h ❑ b. MINIMUM ANNUAL R I g.p.h, M42.
<br />WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATiC PUMP SHUTDOWN? za YES M4I.
<br />❑
<br />WIT T_ ELLD FATLURE/DISCONNECTiON TRIGGER AUiOMATIC PUMP SIIUTDOWN? ❑ b. NO 4.1NT1=GRiTYTESTING �;
<br />1. YES ❑ h, NO Moa
<br />TEST 17REQUENCY: :_; a, ANNUALLY ❑ h, EVERY 3 YEARS ❑ c. OTHER (Specify) M45. ti14(,.
<br />❑ s. VISUAL MONiTORINCrDONE: ,�a,DAILY ❑ b. WEEKi_Y*
<br />Requlrns nacncy npprovnl - AII�,v��r mm�iC. mring o(unbunul Pr,ornency e n �E SNCTFM OPF.FtA'T[D'• M47
<br />TPiNG IS SUCTION PIPING Mii1_.'FING ALL REQUIREMENTS FOR FXEMPTiON FROM MONITORING PER 23 CCR §2636(aN3) 0"'y Par
<br />❑ 7, NO PRODUCT OR REMOTE Fll d. PiPING IS CONNECTF.T) TO THE-'UST(s)
<br />Q 99.OTPIER (Specify)
<br />Mnn,
<br />SJCF1-ID-d (07/03) -1/4
<br />07/23/03
<br />
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