BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

,ONIFIED PROGRAM CONSOLIDATED-FORM, UNDERGROUND STORAGE TANK MONITORING PLAN-(Pone,I of 2) TYPE OF ACTION ❑I.NEW PLAN ® 1 CHANGE OF INFORMATION 490.1 PLAN TYPE ® L MONITORG IS IDENTICAL FOR ALL USTS AT THIS FACILITY. a9a_ IN (Chink one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM I. FACILITY INFORMATION FACILffY ID p(Ag¢ncv Use Only) _ 1 BUSINESS NAME(Sam as FACILITY NAME)Costco Tracy Gas Station#658 3. BUSINESS SITE ADDRESS 3250 West Grantline Road 103, CITY Tracy In. IL EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing,preventive mimrnancc,and calibration of monitoring eyuipmrnt(e.g.,sensors,probes,line Ieak dclectors,etc.)must be performed at the frequency specified by the equipment manufacturers'iwtmclions,or annually,whichever is more frequent,and that such work must he perforni d by qualified persmmel. (23 CCR '2632,2634,2638,2641) MONITORING EQUIPMENT IS SERVICED I.ANNUALLY 99.OTHER(Spy): ai0.4 waw 111.MONITORING LOCATIONS I.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR 12132, 214 IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): 1.CONTINUOUS ELECTRONIC TANK MONffORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT wo-5 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632.3634) SECONDARY CONTAINMENT IS: ❑ a.DRY ® It.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 4908 PANEL MANUFACTURER: Veede Root 0°0.1 MODEL#: TLS•350R 4ao9 LEAK SENSOR MANUFACTURER: Veeder Rest 490.9. MODEL iqS): 7f17g►3g1 09U1° LI 2.AUTOMATIC TANK GAUGING(ATC)SYSTEM USED TO MONITOR SINGLE WALL TANKISL(23 CCR 126/3) 4WI I PANEL MANUFACTURER: _._.._ 49a1z MODEL N: 49013 IN-TANK PROBE MANUFACTURER 690.1° MODEL#(S): _ _ 490.16 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILYINIGHTLY ❑ c.WEEKLY 49x16 ._ _._. ❑ d.MONTHLY ❑ e.OTHER(Spmify): ~1 PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g.p.h. ❑ C.OTHER(Specify); w is 4W19 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR 1266.0: 090.20 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR 12f451. TESTING PERIOD ❑ a.36 HOURS ❑ b.60 HOURS wan 9P22 5.TANK INTEGRITY TESTING(23 CCR 12W.1): +90.zs TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Spoeify): 4W1-24 4WLI ❑99.OTHER (Specify): 49 26 1W21 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHODS)(Check all that apply) I.CONTINUOUS MONITORING OF PRE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND w0.2e VISUAL ALARMS. (13 CCR 12636) SECONDARY CONTAINMENT IS:®a.DRY ❑b.LIQUID FILLED 0c.PRESSURIZED ❑d.UNDER VACUUM 490"9 PANEL MANUFACTURER:Veeder Rom(VR) 490.3° MODEL#: TLS-340R i90.'I LEAK SENSOR MANUFACTURER __VR fYmp Intartar sensn VR 7%380:352 Reg.STP&206 Prem.STp as of 2/5/1 4..3' MODEL.#(S): 352 Reg.&206 Preen 4 t1 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ®a.YES ❑It.NO 4WI4 FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ®n YES ❑It.NO A90.11 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g p.L LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED(23 CCR 2636 49 % MLLDMANUFACTURER(S); 490.37 MODEL#(S): 4W458 ® 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 1.p.6.LEAK TESTS (23 CCR 12636) ~9 ELLD MANUFACTURERISIVedv Rest "so'siI 1 MODEL S: 0684 PLED 49wi PROGRAMMED M LINE LEAK TEST: ® I.MINIMUM MONTHLY 0.2 g.p.h. ® 2.MINIMUM ANNUAL 0.1 g.p.h. J40a2 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ®Is.YES ❑b.NO J40"11 ELLD FAILUREIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ®a.YES ❑b.NO 49x4+ 4.PIPE INTEGRITY TESTING w 5 TESTFREQUENCY C9 a.ANNUALLY b.EVERY3YEARS E3 c.OTHER(5 i ) 49 4917 5.VISUAL PIPE MONITORING. 4904r FREQUENCY ® a.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED' +9b4a •Albn'W Br wo„uwin of=ti-i ctita,,my sia w psor,o*m HK 2nL b 3 ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR$214(aK3R• 4W50 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7IS CONNECTED TO THE TANK SYSTEM 490.51 ❑ 99.OTHER(spxify) +9°.52 490.53 UPCF UST-111(12/2007)114