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Ask AWL UNIFIED PROGRAM CONSOLIDATED FORMW UNDERGROUND STORAGE TANK MONITORING PLAN-(Page 1 of 2) TYPE OF ACTION ❑ 1.NEW PLAN ❑ 2.CHANGE OF INFORMATION 490-1 PLAN TYPE 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490.2 (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S)- 1. FACILITY INFOR TION FACILITY ID#(Agency Use Only) - - 1 BUSINESS NAME(Same as FACILITY NAME) T l Ls • / it o 3. BUSINESS SITE ADDRESS , SA�� 103. CITY -� 9104 H.EQUIPMENT TESTING AND PREVENTIVE MAINTEN Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc)muta pe a ere en 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 264 _ _ _ MONITORING EQUIPMENT IS SERVICED ® I.ANNUALLY �-❑ 99 OTHER(Specify): � � l 1 G - 490-3b III.MONITORING LOCATIONS RANJOAQUINCOMW ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. El 2.SITE PLOT PLAN/MAP PREVIOUSLY SUB11MOQ J2632, 2634 490-4 HEALP4 DEPARTMENT IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490-5 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: V gl3pls(L p p pT --- - 490.7. MODEL#: _- �- 490.8 LEAK SENSOR MANUFACTURER:V g17d1f, F4)0 1 490.9. MODEL#(S): -19 t-(3C1 1 �-1 CK1 490-10 ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 490-11 PANEL MANUFACTURER: 490-12._ MODEL 4: 490-13 IN-TANK PROBE MANUFACTURER: - 490-14_ MODEL#(S): - 490-15 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b DAILYINIGHTLY ❑ c.WEEKLY 490-16 ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17 ------ ---------------------------------------------------------------------------------------------------------------------------------------------- PROGRAMMED TESTS: ❑ a.0.1 h. ❑ b.0.2 h. ❑ c.OTHER(Specify): 490-18 g•P• g p- ( p '7): 490-19 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490-20 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: [:] a.36 HOURS [Ib.60 HOURS 490-21 a9az2 ❑ 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 TEST FREQUENCY: E] a.ANNUALLY El b.BIENNIALLY El c.OTHER(Specify): 490-24 90 25 ❑ 99.OTHER (Specify): 490-26 490-27 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-28 VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS:®a.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM 490-29 PANEL MANUFACTURER: VVY0&T j oqT 49131 i MODEL#: TUS - l7 490-31 LEAK SENSOR MANUFACTURER:V15-15, ►Z oS 0-9132 MODEL#(S): 1- D-aCfr 490-33 ------------ PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ❑a.YES ❑b.NO 490-34 FAILUREMISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49135 ❑ 2.MECHANICAL LINE LEAK DETECTOR(MLLD)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) -_- 490-36 MLLD MANUFACTURER(S): 490-37 MODEL#(S): 490-39 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490-39 - - --- ---- --------- -------------- --- 490.4--0. 490-41 ELLD MANUFACTURER(S) -_ 1 DEL#(S): CQ 1 - - - ------------------------- � �.Lis-------------------------------- MO- - - ------ PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. 491-42 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490-43 ELLD FAILUREIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490-44 ❑ 4.PIPE INTEGRITY TESTING 490-45 TEST FREQUENCY ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHERS eci CtliM6490-47 ❑ 5.VISUAL PIPE MONITORING. 490-48 FREQUENCY [Ia.DAILY [:] b.WEEKLY E]c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* .�f`;"� 490-49 -Allowed for monitoring of unburied emergency enerator fuel piping only per HSC§25281,5(b)(3) F ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA[23 CCR§2636(a)(3)1. 0-90-50 ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYS °M', 49151 49152 ❑ 99.OTHER(Specify) 490-53 uN C 3- UPCF U 1/4