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D PROGRAM CONSOLIDATED FO� <br /> MW UNDERGROUND STORAGE TANK <br /> MONITORING PLAN - (Pae 1 of 2) <br /> TYPE OF ACTION ❑ 1.NEW PLAN ® 2.CHANGE OF INFORMATION 490-1. <br /> PLAN TYPE ® 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 49(1-2. <br /> (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): <br /> I. FACILITY INFORMATION <br /> FACILITY m#(Agency Use Only) 1 <br /> BUSINESS NAME(Same as Facility Name or DBA) ,-Eleven # .32190 3 <br /> BUSINESS SITE ADDRESS 103. CITY Io4 <br /> 4943 S. Kingsley Stockton <br /> II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE <br /> Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must be performed at the frequency specified <br /> by the eyuiP_rEmt manufacturers'instructions_or annum whichever is more frequent.Such work.must <br /> _be Performed uaq I ed�usonneL 1z3(?:RL2632,u3a,2638_2641] <br /> MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY ❑ 99.OTHER(Specify): 490.3a. <br /> 490-3b. <br /> III. MONITORING LOCATIONS <br /> ❑ 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN ® 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED [23 CCR§2632,26341 490-47 <br /> IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) 'check appj6) <br /> ® 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACES)OR SECONDARY CONTAINMENT VAULT(S) 490-9. <br /> WITH AUDIBLE AND VISUAL ALARMS.[23 CCR§2632.26341 <br /> SECONDARY CONTAINMENT IS: ❑ a.DRY X b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 490.6' <br /> PANEL MANUFACTURER: Veeder-Root 490-7. MODEL#: TLS-350 490-8. <br /> LEAK SENSOR MANUFACTURER: Veeder-Root 490"9' MODEL#( _S): 794380-302 490,10. <br /> �2. M <br /> AUTOATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANKlSI.IZ3 ccR-26431 a9di1. <br /> PANEL MANUFACTURER: 490-12. MODEL#: 490-13. <br /> IN-TANK PROBE MANUFACTURER: 490.14. MODEL#(S): 490,15. <br /> LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAI,Y/NIGHTLY <br /> ❑ c.WEEKLY 4W16. <br /> ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17. <br /> _ PROGRAMMED TESTS:_ � a.0.1 g.p.h____ El b.0.2_h__..-.____[I cc.OTHER(Specify): 490.18. <br /> ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILWTION[z3 ccR 42646.11 ------ --490-20. <br /> ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)[23 CcR-2645] TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 49 4W21. <br /> ® 5.TANK INTEGRITY TESTING PER[23 CCR-2643.11 ..............._.._...."..._______..__.....__ 4WM. <br /> TEST <br /> FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ® c.OTHER SB989 every 36 months 494 <br /> 25. <br /> _ 490-N. <br /> ___ .._-_____..__.._....__."_......_..__....."_._.__._.._.._..____....._.."____"_".___.._......"."....."...."_____...._."."...."._.....______........_"___.............. . ......_" <br /> ® 99.-_OTHER__ (Specify): Overfill protection-Flapper ...... <br /> 890-z6. <br /> 490-2]. <br /> V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) �i ack`n <br /> ® 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 490-28. <br /> [526 6j SECONDARY CONTAINMENT IS: ® a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 49029. <br /> PANEL MANUFACTURER:Veeder-Root 490"30' MODEL#: TLS-350 49031. <br /> LEAK SENSOR MANUFACTURER: Veeder-Root 490,32. MODEL#(S): 794380-208 49 33. <br /> PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN, ® a.YES ❑ b.NO 490-34. <br /> FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑ b.NO 490-35. <br /> 2.MECHANICAL LINE LEAK DETECTOR(MELD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF 490-36- <br /> PRODUCT FLAW WHEN A LEAK IS DETECTED.123 CCR-26361 <br /> MLLD MANUFACTURER(S): 490.37. MODEL#(S): 490,38. <br /> ® 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.In CCR§26361 490-39. <br /> ELLD MANUFACTURER(S):Veeder-ROOT 490'40 MODEL#(S): PLLD 490-41. <br /> PROGRAMMED IN LINE LEAK TEST: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g,p.h. 49042. <br /> ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 490'43. <br /> ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO d90-"- <br /> 0 4.PIPE INTEGRITY TESTING. ---- -----'--- - - -490 45. <br /> ISTEST FREQUENCY___❑ a.ANNUALLY [I b.EVERY 3 YEARS ® c.OTHER(Specify) M89 every 36 mo. 490-46' <br /> ❑ 5.VUAL PIPE MONITORING. ------- --'--- " 4 4902-08. <br /> FREQUENCY: ❑ a.DAILY ❑ b.WEEKLY ❑ C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED. 490'49. <br /> __❑ SU <br /> ______ -LL- - 1nll ONy pv I SC jg5 LI.5(6 3 <br /> 6. CTION PIPING MEET'S EXEMPTION CRITERIA.[M CCR§2636(.x3)] 49050. <br /> ❑ 7.NO REGULATED PING PER HEALTH AND SAF'EPY CODE,DNISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM. 4945E <br /> ❑ <br /> 99.OTHER(Specify) ---------'---"--a9asz <br /> 490-53. <br /> UPCF UST-D(12/2007)-1/4 www.unklemorg <br />