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•UNIFIED PROGRAM CONSOLIDATED FOI& UNDERGROUND STORAGE TANK MONITORING PLAN-(Pae 1 of 2) TYPE OF ACTION ® 1.NEW PLAN ❑ 2.CHANGE OF INFORMATION 490-1 PLAN TYPE ® L MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 0Y°-2 (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(.S)- L FACILITY INFORMATION FACILITY ID#(Agency Use Only) _ _ I BUSINESS NAME(Same as FACILITY NAME)Loves Travel Stop#538 3. BUSINESS SITE ADDRESS 15250 North Thornton Road Ina_ CITY Lodi 104 H.EQUIPMENT TESTING AND PREVENTIVE 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§263212634.2638,2641) ---------------------------------------- ____-,_-____,________-___ MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY ❑ 99.OTHER(Specify): 490 3b IH.MONITORING LOCATIONS ®1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. [12.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 2634)4904 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 VAULTS)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: Veeder-Root 490-2 MODEL 4: TLS-350 490"8 __ _ __ ___-_-_--__-__-__-___________--_---____-__--___-___--------------__-- _ __-_"__"__"__"__"_"_"__""_____"________-_ LEAK SENSOR MANUFACTURER: Veeder-Root - MODEL#(S): 794380-303 4911-9 49Ri9 ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 4901 I PANEL MANUFACTURER: 490-12. MODEL#: 490-13 ____'_______-_---_-_-----------------_--_ IN-TANK PROBE MANUFACTURER: 490-14. MODEL#(S): 490-15 ..__..-___.-_._._____________""_____"_____""--------------------_-__-_____--__-_---_----_ LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490-16 ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17 __________-____-___--__-_--_______-_--__-_--_"__"__"_"_""_"____"__"__"__"___-__________""_"_"____"_______""____"_"___"__"__"_"__"__"____"__"_____-_-_________-----_-----------------_-_-_ PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): 490 188 ❑ 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 90-22 ❑ 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 490-24 490-25 ❑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 PEPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 49°-28 VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS:❑a.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ®d.UNDER VACUUM 490-29 PANEL MANUFACTURER:Veeder-Root 490"30 i MODEL#: TLS-350 490-31 LEAK SENSOR MANUFACTURER: Veeder-Root 490x2 i MODEL#(S): 857280-100 490-33 -_-----_-------------------------------------------_---_--------------- ___-________-"-_____._____"_____"__"__"__"__""____""_"__"__""_-____________ PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ®a.YES ❑b.NO 490-4 FAR.UREMISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. E 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§2636) _ 490-36 MLLD MANUFACTURER(S): 490-37 MODEL#(S): 490-38 ® 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490-39 490-4n. ---------------------------------- --- HELD MANUFACTURER(S)Veeder-Root MODEL#(S): PLLD 848480-001 490-41 PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2. MINIMUM ANNUAL 0.1 g.p.h. 49042 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ®a.YES ❑b.NO 49043 ELLD FAILURE/DISCONNECTION 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.OTHER(Specify) 490-46490-47 ❑ 5.VISUAL PIPE MONITORING. 49048 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 490-49 'Allowed for monitoone of unburied emergemy gewraor fuel pipmg only er HSC§25281.5(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 6.7 IS CONNECTED TO THE TANK SYSTEM 490-5I ❑ 99.OTHER(Specify) 490-52 490-53 UPCF UST-D(1212007)1/4