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07/07/2011 08:53 2097270859 GEORGE'S #1637 P.002 /004 "- MWIV. D PROGRAM CONSOLIDATED FORV UNDERGROUND STORAGE TANK MONITORING PLAN- e 1 of 2 TYPE OF ACTION ®1.NEW PLAN ❑ 2.CHANGE OF INFORMATION 6M PLAN TYPE ® 1.MONITORING IS IDENTICAL FOR ALL USTS AT T14TS FACTLITY. 492 (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM v} n�n dNl 390 FACILITY ID#(Agency Um Only) _ BUSINESS NAME(Same as FACILITY NAME) s. George's Mini Mart BUSINESS SHE ADDRESS 1°3 C1TY tax 18662 N HWY 88 Lockeford CA 95237 FEc' ,�.11 T1 i1f 'IIET _ Te sfiti ,imc cmive maintenance,and calibration of monitoring egrdpman(o,g.,sonsots,probes,line leak detectors,etc.)most be pcafotmed at the frequency specified by the equipment manufnettm='insawvons,or amually,whichever Ls more fiNu t,and that such work must be perfo-od by qualified pa mci- (23 §2632'2634,2638,2641) MONIFORING EQUIPMENT IS SERVICED ® I.ANNUALLY ❑ 99.OTHER(Speofy): look ❑1.NEW SITE PLOT PLANT MAP SUBMITTED WfIH THIS PLAN. ❑2.SITE PLOT PLAN/MA.P PREVIOUSLY SUBMITTED, (23 CCR VAA 2634)490.4 ® 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 49x4 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,263x!) SECONDARY CONTA[DA4Q4T IS: ❑ a DRY ❑ b.LIQUID FILLED ❑ 0.PRESSURIZED ❑d.UNDER VACUUM 4906 PANEL MANUFACTURER: GEbaro 4 490-7' i MODEL#: EMC 49us LEAK SENSOR MANUFACTURER: VEEDER ROOT 690.9' i MODEL#(S): 420 �.Y. 49x19 2.AUTOMATIC TANK GAUGING(ATC)SYSTEM USED TO MONITOR SINGLE WALL TANK(a(23 CCR§2643) 49011 PANEL MANUFACTURER: dB0.12' MODEL#: 490.13 _IN TANK PROBE MANUFACTURML _ _ d90''4 MODEL#(S)-. a 15 LEAK TEST FREQUENCY: ❑ a CONTFN OUS �- �❑ b.DAILYMIGHILY C1 c.WEEKLY 410'16 ❑ d.MONTHLY ❑ e.OTHER(Specify): 9917 PROGRAMMED TESTS: ❑ a 0.1 gp-h. ❑ b.02 g.p.h. ❑ o.OTHER(SpWfy): __ - aoiv ❑ 3_MONTHLY STATISTICAL INVENTORY RECONCH.LITION(23 CCR§Z646A): 490.20 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a 36 HOURS ❑ b.60 HOURS 490-71 S.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 TEST FREQUENCY: ❑ a.ANNUALLY ❑ a BIENNIALLY ❑ c.OTHER(Spocify): 49014 4W25 ❑99.OTHER (Spcc)fy): �Z7 --: -- - Ll t.CONTINUOUS MONITORING OF PIPE/ OND AND OT PIPINGS - -- f f U1MP(S) HER SECARY CONTAINMENT WITH AUDIBLE AND a9yT8 VISUAL ALARMS. (23 CCA§2636) _SECONDARY CONTAINMENT IS:❑a DRY ❑b,LIQUIDFILLED ❑c.PRESSUR.UM ❑d.UNDER VACUUM d7029 PANELMANUFACTURER: 4930 j MODEL#: 4931 LEAK SENSOR MANUFACTURER: 40.32 i MODEL#(S): 470.33 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(Le.,TURBINE)SHUTDOWN. ❑a YES ❑b-NO .49x34 FAILURMISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a YES ❑b.NO 490-35 ® 2 MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.pAL LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED 20 CCR§2436) 49x36 MLLD MANUFACTURERS}UMI,RED JACKET 490.31 MODFL#(S): 99LD2000 49oas ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROVIINELY PERFORMS 3.0 g.p.h.LEAK TESTS (33 CCR§2636) 49939 61.1,0 MANUFACTURER(S) _ 49 . 1 MODEL 9(3): 07051023 PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 02 g.pJL ❑ 2.MINIMUM ANNUAL 03&p.h. 4904z FIT DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. 0 a YES ❑b.NO a0O ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN_ ❑a.YES ❑b.NO 49DM ❑ 4.PAPE INTEGRITY TESTING 49909 TEST FRE UENCY ❑ a ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER 4904649047 5.VISUAL PIPE MONITORING, 4904e FREQUENCY ❑ a DAILY ❑ b.WEEKLY ❑c,WN,MOMiiLY&EACtl TIME SYSTEM OPERATEI)v 49049 •kb.vd ar af09b9ricd Ml OPLOR Only=ase 1 3 ❑ &SIIC [ON PIPING MEETS E3CF.MPTTON CRITERIA[23 CCR§2636(a)3))• 490.50 ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 206 CHAPTER 6.715 CONNECTED TO THE TANK SYSTEM 49041 ❑ 99.OTHER(Specify) 5532 r:oc-c r�cr_n r 1�nmn r i4