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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUNDSTORAGETANK MONITORING PLAN - (Page I of 2) TYPE OF ACTION ® L NE W PLAN ❑ 2.CHANE OF INFORMATION 490.1. PLAN TYPE ® 1.MONITORING IS IDENTICAL FOR L USTs AT THIS FACILITY. 490-2. (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) I I - - 1 BUSINESS NAME(Same as Facility Name or DBA) Chevron Station# 210997 3 BUSINESS SITE ADDRESS 1442 A Colon Drive 103. CITY °9 Y Ripon, CA 95366 H. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must be performed at the frequency specified [heaugi en t manufacturers'instructions,or,annual,whicheverismore frequent.Such wo_r_k_mustb_eperformed by qualified personnel.[23ecx§2632,2634,2638,26411 MONITORING EQUIPMENT IS SERVICED M L ANNUALLY ❑ 99.OTHER(Specify): 49 3h IH. MONITORING LOCATIONS ❑ 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN ® 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED [23 CCR§+632.2634] 4904. k IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) ha'eeall L CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 49-5. VAULT(S)WITH AUDIBLE AND VISUAL ALARMS.[23 CCR§2632.2634] SECONDARY CONTAINMENT IS: ® a.DRY b.LIQUID FILLED ❑ c.PRESSURIZED❑ d.UNDER VACUUM 490-6. PANEL MANUFACTURER: Veeder-Root 4947- MODEL#: TLS-350 496-8, LEAK SENSOR MANUFACTURER: Veeder-Root 499- MODEL#(S): 409 49-10. _______---_-._._.. .._____._____� .. ..___...._..._..._._._.._....._..............._....................._...._._._...._.__..._.__. �} 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO OND'OR SINGLE WALL TANK(S).[23 CCR 42643] 49o-I f PANEL MANUFACTURER 490'12. MODEL#: 490'13. IN-TANK PROBE MANUFACTURER: 490-14. MODEL#(S): 490-15. LEAK TEST FREQUENCY: ❑ &CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490-16. ❑ d.MONTHLY ❑ e.OTHER(Specify): 450.17. PROGRAMMED TESTS: ❑ a.0.1 h. b.0.2 h. ❑ c.OTHER(Specify): 49-18, g.p.h. g.p.h. fY 490.19. ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION R3 CCR§26461] 490-28. ❑ 4.WEEKLY MANUAL TANK GAUGING(MIG)[23 CCR§26461 TESTING PERIOD: ❑ a.36 HOURS ❑ 6 60 HOURS490-21 _ _ 490 22 - �__..__..._...._........___._ 490-23. ❑ 5.TANK INTEGRITY TESTING PER[z3 CCR 42643.❑ TEST FREQUENCY: ❑ a.ANNUALLY b BIENNWLLY ❑ c OTHER(Specify) 4�25.24. 4. ❑ 99.OTHER(Specify) 427, a9-n. V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) hatap as thata l ® 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S) OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 190-28. [13 CCR SECONDARY CONTAINMENT IS: M a.DRYfbLIQUID FILLED ❑ c.PRESSURIZED❑ d.UNDER VACUUM 19-29, 42636] PANEL MANUFACTURER: Veeder-Root 49-30. MODEL#: TLS-350 190-31' LEAK SENSOR MANUFACTURER: Veeder-Root 49-32' MODEL#(S): 208 IN-33. PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ® a.YES ❑ b.NO 19034 FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑ b.NO 190-35. ❑ 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT R 5UTjWELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED.[23 CCR§263 51 MLLD MANUFACTURER(S): 490-31. MODEL#(Sy 19038. ® 3. ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT R UTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.In cM§2636] 190-39. ELLD MANUFACTURER(S):Veeder Root 49040, MODEL#(S):PLLD 19041. PROGRAMMED IN LINE LEAK TEST: ❑ &MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. 19042. ELLD DETECTION OF A PIPING LEAK TRIGGERS AL OMATIC PUMP SHUTDOWN. ® a.YES C3b.NO 19043. ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMIATIC PUMP SHUTDOWN. ® a.YES ❑ b.NO 1 o . ❑ 4.PIPE INTEGRITY TESTING. 190.45. TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS❑ c.OTHER(Specify) 490446, T ❑ 5.VISUAL PIPE MONITORING. 49n48. FREQUENCY ❑ a DAILY b.WEEKLY ❑ c MM.MONTHLY&EACH TIME SYSTEM OPERATED- 49-49. Alb ed br Mam�ofwdmM eme,g nryg t fuel RRutg oNyy tLSC�252815(b(�(3) _, ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA[23 CCR 26361a)(3ll 49-50. ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM. ,490x1' ❑ 99.OTHER(Specify) - -- 49-53.