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iJNIFIED PROGRAM CONSOLIDATED FOR UNDERGROUND STORAGE TANK MONITORING PLAN- Pae 1 of 2) TYPE OF ACTION ❑ 1.NEW PLAN ff2.CHANGE OF INFORMATION 490-1 PLAN TYPE ❑ 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490.2 (Check one item only) e.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S) I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) - - 1 BUSINESS NAME(Same as FACILITY NAME) Al �� 3. BUSINESS SITE ADDRESS 101- CITY 104. II:EQUIPMENT TESTING R 44EVENTIVE MAINTENANCE Testing, preventive maintenance,and calibration of monitoring equipment(e.g.,sensors, probes, line leak detectors,etc.)must be performed at the frequency specified by the equipment manufacturers'instructions,or annually,whichever is more frequent,and that such work must be performed by qualified personnel. 23 CCR L2632. MONITORING EQUIPMENT IS SERVICED 2-T ANNUALLY ❑ 99.OTHER(Specify): ago-eb III.MONITORING LOCATIONS ❑ 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. .SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 2634)490-4 IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490-5 VAULTS)WITH AUDIBLE AND VISUAL A ARMS. (23 CCR§2632,2634) SECONDARY CONTAINMENT,IS: a.DRY ❑nb.'"LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490-6 -_---__---PANEL MANUFACTURER: Y _ J 490-� MO_DEL -_ LEAK SENSOR MANUFACTURER: da t °90-9. MODEL#(S): 0�= O - -lo 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR 940%J) 490-11 PANEL MANUFACTURER: 490-12. MODEL#: 490-13 _ IN_-TANK PROBE MANUFACTURER: 49x14. MODEL#(S): LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILYMIGHTLY ❑ c.WEEKLY 490-16 ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17 --------------------------____--___------------- - __ -_______.-. _. _ __ __ _________ PROGRAMMED TESTS: ❑ a.0.1 gF.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): 4490-19 ❑ 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 ❑ b.60 HOURS 490-21 490-22 ❑ 5.TANK INTEGRITY TE5.TING(23 CCR§2643.1): 490 23 TEST FREQUENCY: V a.ANNUALLY El b.BIENNIALLY ❑ c.OTHER(Specify): 490-25 El99.OTHER (Specify). 490-26 490-21 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that appl 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: [ffa.DRY ❑b.LIQUID FILLED c.PRESSURIZED ❑d.UNDER VACUUM 090-29 PANEL MANUFACTURER:___ _ _ 490'30 MODEL! Lr 0 - _ r" LEAK SENSOR MANUFACTURER: / /�U 490-32 MODEL#(S). y 490J3 PIPING LEAK ALARM TRIGGERS A TOM TIC PUMP(i.e.,TURBINE)SHUTDOWN. a.YES ❑b.NO 490x4 AI LU RE/DISCONNECTION 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.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED_23 CCR X�2/636) - 490-36 MLLD MANUFACTURER(S). I/ 490-37 MODEL#(S): ❑ 3.ELECTRONIC LINE LEAK DETECTOR LLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490-39 ELLD MANUFACTURERS) -_-_ 490-40.1 MODEL#(S)_ _ _ 49CWt _--_ --- -- -----------_--_-_-_-_---_._.-__ ____._.___ ______________________________ _ PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. 490-42 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49043 UL LLLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. Ela.YES ❑b.NO 490-44 4.PIPE INTEGRITY TEST G 490-45 TEST FREQUENCY a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 49046490.4] ❑ 5.VISUAL PIPE MOlyt'I'ORING. 490411 FREQUENCY [Va.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED- 490-49 •Allowed fmmonimrin ofunbuded eme a ermorfuel pipinmonlrHSC§252815(b)(3) ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA(23 CCR§2636(a)(3)]. 490-50 ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.71S CONNECTED TO THE TANK SYSTEM 490-51 ❑ 99.OTHER(Specify) 490-52 490-53 UPCF UST-D(12/2007)1/4