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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK TYPE OF ACTION MONITORING PLAN- Pae 1 ot2 I.NEW PLAN 2.CHANGE OF INFO PLAN TYPE 1.MONITORING IS IDENAT TICAL FOR ALL USTs ATMTHIFACILITY, 1901 (Check one item ON ❑ 2 THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM( SL_. 49az FAeILITY ID a(Agency Uee o ry) L FAGH ITy INFORaypTTON BUSINESS NAME(Same as FACILITY NAME) r, BUSINESS SITE ADDRESS3l r �n [C�7/ 3 L V . � na CITY IL EQUIPAUN'r an a. Testing,preventive maintenance,and calibration of monitorinG AND PREVENTIVE Mr#INTENANCE s23 CCfil d by the equipment manufacturers'instmctions,or annually,aequipment yulwhiehevegis more frequent sold a detectors, h tors,etc.)must bo 23 CCR 2632,2634,2638 2641 Performed at the frequency MONITORING E work mat be Performed by qualified personnel EQUIPMENT S SERVICED 1.ANNUALLY ❑ 99.OTHER 5 11X.MON1f0 ( Peclfi): 9x3. I.NEW SITE PLOT PLAN/M AP SUBMITTED WITH THIS PLAN. RPit2SICsTETAONN'/SMAP PREVIOUSLY SUBMITTED. (23 CCR§2632 490.3b 2634 90.0 N:TANK MONITO NITO IN PERFORMED USING I.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTRTt SPACE OR SECONDARY CONTAINMENT 490-s VAULT(S)WITH AUDBLEAD VILAMS. CC ,2634) WQiG METRO INSUALAR (23 R§2632 SECONDARY_FACTURC_ONTAMMENT IS: PANEL MANUER: --- �,a DRY b LIQUID FILLED ❑ c.PRESSZED +- URI_ ❑d.UNDER VACUUM 19oe LEAK SENSOR MANUFACTURER: 49x9, MODEL#: 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SIN(:TF we 4" - Is0T Lora 1� asn.ro PANEL MANUFACTURER` LL TANIrr -� (23 CCR§2643) 49 lj - IN_-_TA_NK PROBE MANUFACTURER: - - MODEL q�__ 4yo-t3 TES LEAK T FREQUENCY: ---- - - 4 14 MODEL NL)t �- ❑ a.CONTINUOUS -- '-'----- T9aT3 ❑ b.DAILYMIGHTLY --'----- _._- ❑ C.WEEKLY 49um d.MONTHLY PROGRAMMED TESTS: _ � aOTHER(S i ) 4W17 ❑ bN(2 gp.h. ❑ c.OTHER(Speci : _____.-____ ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION 23 �) °90'ts ❑ 4.WEEKLY MANUAL TANK GAUGING(MTC)(23 CCR 264$ ( CCR§2616.U: w 20 § ) TESTINGPERIOD; 4W21 5.TANK INTEGRITY TESTING(23 CCR§2643.1): ❑ a.36 HOURS ❑ b.60 HOURS 49x31 TEST FREQUENCY: ❑ a.ANNUALLY 190-23 ❑ b.BIENNIALLY ❑ c.OTHERfy 9o-z3 (S PeOi ): 4190.34 ❑99.OTHER (Specify): +90.x6 V,PIPE MONITORING IS PERFORMED 490-26 USIlYG THE FOLLOWING- S 490.21 I.CONTINUOUS MONITORING OF PIPE/PIPING SUMPS)AND OTHER SECONDARY CONTAINMENT WITH A�UDIRLE�ANfD PPIY� 4w2'$ ISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS: .DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM PANEL MANUFACTURER: _--- +9az9 490-0 ��-3 LEAK SENSOR MANUFACTURER_ MODEL K: Q +9oar a9a3z_ MODELN(S): Zj0 _ Q490-33 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e,TURBINE)SHUTDOWN. .MECHANICAL LINE IONLEA OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN, �a.YES ❑b 490.31 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS3.0 MP.h.LEAK WN. ClAND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED 23 CCR 2636 MLLD MANUPACTORER(S): �- -----_Sy- _ 190.1) __ 19F MODEL ❑ 3.ELECTRONIC LINE LEAK DETE(I OR(ELLD)THAT ROUTINELY PERFORMS 3.Ogp.h,LAK TESTS (23 CCR 2636 C 19u3e _ ELLDMANUFACTURER(S)__-_-_- -- --_--- 490.39 _ _____ PROGRAMMED IN LINE LEAK TEST: ----- _!MODEL q(S�- - 490.41 ❑ I.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 h. __-_-_--4- ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN, &0. ELLD FAILUREIDISCONNEC TION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a'YES ❑b.NO 190.13 4.PIPE INTEGRITY TE TING 49x13 ❑a YES ❑b.NO 49 TEST FRE UENCY a.ANNUALLYP b.EVERY 3 YEARS c.OTHER(Specify) 5.VISUAL PIPE NITORINC. JF j 490.46490.7 FREQUENCY a.DAILY b.WEEKLY ❑c.MIN.MONTHY&EACH TIME SYSTEM OPERATED' 190'u All9we4 foe m9ni39nn afa.DAI Y mi ea9EK ❑ 6,SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2b)(3) 3)1, 49x19 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 49o-w 090 31 ❑ 99.OTHER(Specify) LL rlt y Q :Jf :990x5, '•A� �PC-wl ot-L MP �-� j SLt.;xa �T rxp, eLL) ( 6 UPCFUUSSTD(12 067)U4DteSCl �`lP -I}t.`J, �c:'Q..fuQ lb. C(e.ae. Ii-t IIa; 1IIpjLt5C1'_iU 1 c-'i.jv, �„t p �i l 15LLry-P