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far- Pm �NIFIED PROGRAM CONSOLIDATED FOR UNDERGROUND STORAGE TANK MONITORING PLAN-(Pae I of 2) 4'w-I TYPE OF ACTION [011.NEW PLAN E 2.CHANGE OF INFORMATION Ph (��/��V�1�V�I ^ 190-2 PLAN TYPE E I.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. HEALTH DEI PTMENT LAN (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): _ - I. FACILITY INFORMATION FACILITY ID#(Agenry Use Only) - - FTJ BUSINESS NAME(Same as FACILITY NAME)COSTCO WHOLESALE GAS STATION#1031 BUSINDRESS 2440 DANIEL STREET 03 CITY MANTECA 04 ESS SITE AD If. 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 by the equipment manufacturers' instructions.or annually,whichever is more frequent,and that such work must be performed by qualified personnel. (23 CCR§2632_2634.2638.26411_____________________________..________-_______.-_______-_______._____.______--_____.______.-______.---___.____________..._-----_--________.__ MONITORING EQUIPMENT IS SERVICED E I.ANNUALLY ❑ 99.OTHER(Specify): 490-3b Ill. MONITORING LOCATIONS ❑I.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. E2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CC'R§2632, 2634)490-4 IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): ® L CONTINIIOLIS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACES)OR SECONDARY CONTAINMENT 490'5 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) 490-b SECONDARY CONTAINMENT IS: ❑ a.URY E b.LIQUID FILLED ❑ c.PRESSURIZED ❑d UNDER VACl1UM 411 1 490-R PANEL MANUFACTURER_-VEEDER_ROOT _- - IMODEL#: TLS-350 __ 490-I0 LEAK SENSOR MANU FACTURER: VEEDER ROOT 4900 MODEL#(S): 794380-301 ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 19111 PANEL MANUFACTURER: 490-12. MODEL 9: I---TANK PROBE MANUFACTURER: 400-14 MODEL4(8): 491-1s ______________________________________________-______-________.-.-___-.-__-___.______-_-________________-__________-_.._.__ 490-IG LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILYWGHTLY ❑ c.WEEKLY 17 [I ..-___________..____d.MONTHLY ❑ e.OTHER(Specify): 090-- _ -__________ -________ ________-______---._______ ._______._______-_ ____________.___________..._________________._________.._________--_________.-_________-_______ _ _ ____ _ 490-IR PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTFIER(Specify): 490-19 490-20 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490-21 El 4.WEEKLY MANUAL TANK GAUGING(MTC)(23 CCR§2645). TESTING PERIOD: [Ia.36 HOURS Elb.60 HOURS 490.2, E] 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490 3 4%21 TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 490-25 490-26 ❑99.OTHER (Specify): 490-21 V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) 1.CONTINUOUS MONITORING OF PIPE/PIPING SIIMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 4"0'28 VISUAL ALARMS. (23 CCR§2636)§2636) 00., SECONDARY CONTAINMENT IS: Ea.DRY Eb.LIQUID FILLED []c.PRESSURIZED ❑d.UNDER VACUUM _-----------------------------------------------------------________-.__-______.________________________r__-__------_.__----_--------_---------------_---- PANEL MANUFACTURER:VEEDER ROOT 4B0 30 ago 3 1 MODEL#: TLS-350 ----------------"----------------------------------------------------------------------------------------------------------------------`-------_:_85-080-------------'------------- 490-31 49°-3z MODEL#(4) 857080112 490-14 LEAK SENSOR MANUFACTURER: VEEDER ROOT -___t-_--________:_-._..______-.�.______________________. PIPING LEAK ALARM IRIGG ERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. E a.YES ❑b.NO FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. E a.YES ❑b.NO 90-35 ❑ 2.MECHANICAL LINE LEAK DETECTOR(MELD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF _PRODUCT FLOW WHEN A LEAK IS DETECTED(23 CCR_2636)_ 410-3b MELD MANUFACTURER(S): 490-3] MODEL#(S): 490-39 ® 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490-19 ___-_______-______.__-_.-.-..____...._____....______________________-_____________________________-___________________--49041 ELLD MANUFACTURER(S)VEEDER ROOT 190-4o MODEL#(s),_-PLED(8484) - ----------_----- ___-_..-------------_ _ _________________ _________._____-________._________.________________ 490-42 PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. E a.YES El b.NO 49043 ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. E a.YES ❑b.NO 490-d4 ❑ 4.PIPE INTEGRITY TESTING 49°45 TEST FREQUENCY ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 490-4649041 ❑ 5.VISUAL PIPE MONITORING. 490-48 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED- 490.49 Allowed for monitoring cfunburied emerLency generatoT fuel iping only per HSC 425281.5(6(3 F16.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(x)(3)(. 490-50 ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490-51 490-52 ❑ 99.OTHER(Specify) 490-51 Belshire Environmental Services, Inc.