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11 11 .+1FIED PROGRAM CONSOLI11 DATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN-(Page 1 of 2) 4go"1 TYPE OF ACTION ❑ L NEW PLAN 2.CHANGE OF INFORMATION L90.I PLAN TYPE $A 1.MONITORING IS IDENTICAL FOR ALL USTS AT THIS FACILITY. (Checkoveilemonly) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST 1. ACILITY INFORMATION_EM ' FACE,rrt m x(dgencv Use onlr) J. BUSINESS NAME(Same as FACILITY NAME) Lp,T 0AW r, S el"'FG14p103_ CITY A �� lox. BUSINESS SITE ADDRESS 4$fJ0 S-Hw-' F TAb£ ? I.EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE ui menl(e.g..sensars,probes.line leak detCClom.etc.)must be performed at the frequency Testing•preventive maintenance,and calibmtion of monimring e9 p q p ualifrcd etsotmeL specified by the equipllxnt lnanufuwt 'instructions,or annually whichever is more fre uent,and that such work must be erformed by q P' 23 CCR§2632 2634_2638 2641_._.___._._._--._._____._. ._._. 99.OTHER(Specify): n9o36 MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY ❑ HI.MONITORING LOCATIONS ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. 2.STCE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 2634 90> IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): x99.5 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACES)OR SECONDARY CONTAINMENT avaa VAULTS)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) : MODEL%: -�.-�__. SECONDARY CONTAINMENT IS: (�a.DRY ❑ b.LIQUID FILLED"❑ c.PRESSURIZED ❑d.UNDER VAC[. _._ 4�d 490.7. L- -3 ....----- __._._._--. __._._.._..._._..._.......-_._....._.-__-_____.___-_.____-__..-.._- a9aln 1 MODEL Qjj ._.._LEAK SENSOR MAINFARCTURER:� V - llE"fasalz. MODELES). _-._9_-._Y,O_ Y ..__--_-. x4631 PA_NELM_ANUFACTURER:-___._- _ - _.__.-.__. ___ .___-_._ ____.----_-_ - ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(Sl.(23 CCR§2643) PANEL MANUFAC _ x90-14. MODEL#(S): _ -- -- -_ -- --- - ."-. 4 1 - __ IN-TANK PROBE MANUFACTURER --- c WEEKLY 6 -- ❑ b.DAII.Y/NIGHTLY a90n LEAK TEST FREQUENCY: ❑ aCONfIINOUS ❑ e OTHER(Specify): ❑ tL MONTHLY - .. .._.' 490.19 -- c.OTHER(SpecifY): --------- _ ROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g.p.h. auo.zo ❑ 3.MONTHLY STATISTICALINVENTORY RECONCILIATION(23 CCR§2646.1): 49o-zt ❑ 4 WEEKLY MANUAL TANK GAUGING(MIG)(23 CCR§2645) TESTING PERIOD: ❑ a 36 HOURS ❑ b.60 HOURS aW" . a90.I4 5.TANK IISTEGRI•TY TESTING(23 CCR§2643.1). 4WLI TEST FREQUENCY: ❑ a ANNUALLY ❑ b.BIENNW-LY ❑ c.OTHER(Specify): a94ib x90-27 OTHER (Specify): .G•,..,z. OLLOWING METHODS)(Check all that apply) V PIPE MONITORING IS PERFORMED USING TH 1.CONTINUOUS MONITORING OF PIPING SL'11W(S)AND OTAER SECONDARY CONTAINMENP WIAUTIIBLE AND PIPE/ 4g1I9 VISUAL ALARMS. (2]CCR§2636) VAC _--_ .... Y90.31 SECONDARY CONTAINMENT IS:Ipa.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER 490.33 _7 n 9" 49034 LEAK SENSOR MANUFACI•URER� FARYL_Rom._.__ _-____- a.YES ❑b.NO. -- -PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.c..TURBINE)SHUTDOWN. 49035 STS AND RESTRIC pII,UREOJISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. L a.YES ❑h.NO 90.36 2.MECHANICAL LINE LEAK DETECTOR(NH.LD)THAT ROUTINELY PERFORMS 3.0 g.P•h.LEAK TS W OR SHUTS O Js PRODUCT FLOW WHEN ALEAK IS DETECTED(23------ a MI MODELMLLD n(S)t.D4Y• 4a9oal ❑ 3.ELECTRONIC LINE LEAKE DETECTOR(EO D) M M ETHLY 0.2 g PSS 3� P-h_ IMEL ANNUAL O.ITESTS (23 Rg'p.h NO .-__. 4 J .. PROGRAMMED IN LINE a YES ❑b ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ ' 490sa ❑a.YES ❑b.NO ELLD FAILURE/DLSCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. -------.------ 4.PIPE INTEGRITY TESTING 49645 a9aab 490-47 a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER S ec ) 49wn TEST FRE UENCY [:1a9w9� 5.VISUAL PIPE MONITORING. ❑c. .MONTHLY&EACH TDAE SYSTEM OPERATED' FREQUENCY ❑ a DAILY ❑ 6.WEEKLY •Nlowd f9rrtwnib,m ofaMadd vn c,elm flcl m wl NSC-253SI56 J 490.50 ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(a)(3)]. 4W51 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490 3 ❑ 99.OTHER(Specify) UPCF UST-D(12P2W7)1/4