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UNDERGROUND STORAGE TANK MONITORING PLAN <br /> For use by Unidocs Member Agencies or where approved by your Local Jurisdiction <br /> Authority Cited: Title 23 CCR, Sections 2632(d)(1), 2634(d)(2), and 2641(h) <br /> TYPE OF ACTION 1.NEW PLAN ❑ 2.CHANGE OF INFORMATION Mal <br /> PLAN TYPE MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. M02. <br /> (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): <br /> I. FACILITY INFORMATION <br /> FACILITY ID 9(Agency Use Only) <br /> FACILITY NAME C_{ o t/a Moa. <br /> FACILITY SITE ADDRESS ` C^.T� �V Mae CITY t- 4 rZ�o to M05. <br /> IL EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE <br /> State law requires that testing,preventive maintenance,and calibration of monitoring equipment(e,g.,sensors,probes,line leak detectors,etc.)be performed in MD6 <br /> accordance with the equipment manufacturers'instructions,or annually,whichever is more frequent. Such work must be performed by qualified personnel. <br /> MONITORING EQUIPMENT IS SERVICED V,I.ANNUALLY ❑ 99.OTHER(Specify): Mol. <br /> III. MONITORING LOCATIONS <br /> This monitoring plan must include a Site Plan showing the general tank and piping layouts and the locations where monitoring is performed(i.e.,location of each sensor, <br /> line leak detector,monitoring system control panel,etc.). If you already have a diagram(e.g.,current UST Monitoring Site Plan from a Monitoring.System Certification <br /> form,Hazardous Materials Business Plan map,etc.)which shows all required information,include it with this plan. <br /> IV. TANK MONITORING <br /> MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S):(Check all that apply) Mao. <br /> 1.CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) <br /> SECONDARY CONTAINMENT IS: [ a.DRY ❑ b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM M" <br /> PANEL MANUFACTURER: [/t El2 (zjvn ' M12. MODEL#: -T-1,-c" M13. <br /> LEAK SENSOR MANUFACTURER: 1%E�je e- iz-c3o t Mld MODEL#(S): 4l 1-f SCI a ` L/W MM <br /> ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S) <br /> PANEL MANUFACTURER: M16. MODEL#: Mt 7, <br /> IN-TANK PROBE MANUFACTURER: Mls. MODEL#(S): MM <br /> LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY M20 <br /> ❑ d.MONTHLY ❑ e.OTHER(Specify): M21. <br /> PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b-0-2 g.ph. ❑ c.OTHER(Specify): NM. M23. <br /> 3.INVENTORY RECONCILIATION ❑ a.MANUAL PER 23 CCR§2646 ❑ b.STATISTICAL PER 23 CCR§2646.1 M24_ <br /> ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)PER 23 CCR§2645 <br /> TESTING PERIOD: ❑ a.36 HOURS ❑ K 60 HOURS M25. <br /> ❑ 5.INTEGRITY TESTING PER 23 CCR§2643.1 <br /> TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): <br /> M26. M27. <br /> ❑ 6.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(Requires agency approval) <br /> ❑ 99.OTHER(Specify): Mea. <br /> V. PIPE MONITORING <br /> MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) M30. <br /> 0.1,CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(S)/TRENCH(ES)AND OTHER SECONDARY CONTAINMENT <br /> SECONDARY CONTAINMENT IS, a.DRY' `❑ b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM M31. <br /> PANEL MANUFACTURER: Y Pil' y✓CX� r M3z. MODEL#: �I' - '&- "�3 <br /> LEAK SENSOR MANUFACTURER: =Udz (Zob-t M34. MODEL#(S): -7,!2 q 3F62 J 20Y Mas. <br /> WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN? ❑ a.YES ❑ b.NO M16_ <br /> WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M37 <br /> 2.MECHANICAL LINE LEAK DETECTOR (MLLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF <br /> PRODUCT FLOW WHEN A LEAK IS DETEC D <br /> MLLDMANUFACTURER(s): r; Mag, MODEL#(S): M39. <br /> ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h,LEAK TESTS <br /> ELLD MANUFACTURER: M40, MODEL 4: M41. <br /> PROGRAMMED LINE INTEGRITY TESTS: ❑ a.MINIMUM MONTHLY 0.2 g.p.K ❑ b.MINIMUM ANNUAL 0.1 g.p.h. M42. <br /> WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M43. <br /> WILL ELLD FAILURE/DISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M44 <br /> ❑ 4.INTEGRITY TESTING <br /> TEST FREQUENCY: ANNUALLY El b.EVERY 3 YEARS (kc.OTHER(Specify)i rLGLL1i S M45. M46. <br /> El5.VISUAL MONITORING DONE: C.- <br /> .DAILY ❑ b.WEEKLY' ❑ c.MITA.MONTHLY&EACH TIMF,SYSTEM OPERATED" M47. <br /> •Requires agency approval '•Allowed for monitoring of unburied emergcnuy generator fuel piping only per HSC§25281.5(b)(3) <br /> ❑ 6.PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXEMPTION FROM MONITORING PER 23 CCR§2636(x)(3) <br /> 7.NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) <br /> ❑ 99.OTHER(Specify) M48. <br /> UN-022A-1/5 www.unidocs.org Rev.10/14/03 <br />