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*ft/ UNIFIED PROGRAM CONSOLIDATED-FORI <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN-(Page loft) <br /> TYPE OF ACTION 1.NEW PLAN [32.CHANGE OF INFORMATION ° 1 <br /> B <br /> PLAN TYPE ONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490.2 <br /> (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S)_ <br /> I. FACIIITY INFORMATION <br /> FACILITY ID#(Agency Use Only) - - 1 <br /> 3. <br /> BUSINESS NAME(Same as FACILITY NAME) R <br /> BUSINESS SITE ADDRESS aZ IIS W OSC M ITCpVE 1m CITY T 'C lm <br /> U.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 <br /> specified by the equipment manufacturers'instructions,or annually,whichever is more frequent,and that such work must be performed by qualified personnel. <br /> 23 CCR§2632,2634,2638,2641 <br /> 9034 <br /> MONITORING EQUIPMENT IS SERVICED ®^I'e NNUALLY ❑ 99.OTHER(Specify): 49o.3y <br /> M.MONITORING LOCATIONS <br /> ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. BZ$ITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§7632, <br /> 2634 <br /> IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): <br /> .CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490.5 <br /> VAULT(S)WITH AUDIBLE AND VISUAL ALARMS (23 §2632,2634) <br /> SECONDARY CONTAINMENT IS: ❑ e_DRY En.LIQUID FILLED ❑ C.PRESSURIZED ❑d UNDER VACUUM 4906 <br /> PANEL MANUFACTURER: ;s °90.1. MODEL#: <br /> LEAK SENSOR MANUFACTURER: : t °90'9. MODEL#(S): q .-"3J 490.10 <br /> -CF2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TAMS),(23 CCR§2643) 490.0 <br /> PANEL MANUFACTURER: 49 [Z MODEL#: 490.13 <br /> IN-TANK PROBE MANUFACTURER 090.14 MODEL#(S): 490.15 <br /> LEAK TEST FREQUENCY: ❑ a CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 49°'16 <br /> ❑ d.MONTHLY ❑ e.OTHER(Specify): 49011 <br /> PROGRAMMED TESTS: ❑ a 0.1k ❑ b.0.2 h. ❑ c.OTHER(Specify): °gots <br /> g.p. B�P� 490.19 <br /> ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 49oW <br /> ❑ 4.WEEKLY MANUAL TANK GAUGING(MIG)(23 CCR§2665). TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS own <br /> 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490.v <br /> TEST FREQUENCY: ❑ a ❑ANNUALLY b.BIENNIALLY ❑ c OTHER(Specify): 490x4 <br /> 49 U <br /> ❑ <br /> 99.OTHER (Specify): 490.26 <br /> 490 2M <br /> V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) <br /> 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 49ov <br /> UAL ALARMS (23 CCR§2636) <br /> SECONDARY CONTAINMENT IS: a.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM 4WV <br /> PANEL MANUFACTURER: V °90.30. MODEL#: S- �J 490.31 <br /> LEAK SENSOR MANUFACTURER ,,;� °90.32 MODEL#(S): J�Z,0. 490.33 <br /> PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. Qr a YES ❑b.NO 4WU <br /> FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. 911.YES ❑b.NO 490.03 <br /> 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.p.b.LEAK TESTS AND RESTRICTS OR SHUTS OFF <br /> PRODUCT FLOW WHEN A LEAK IS DETECTED 23 CCR 49 X <br /> MLLD MANUFACTURER(S): 490.37 MODEL#(S): 490.38 <br /> gr 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.pA LEAK TESTS (23 CCR 2636) 49039 <br /> ELLD MANUFACTURER(S) J 49040 MODEL#(S): O-00 1 49n41 <br /> PROGRAMMED IN LINE LEAK TEST: 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. 49or2 <br /> ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. A e.YES ❑b.NO 49043 <br /> ELLD FAILUREMISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. YES ❑b.NO 49044 <br /> El 4.PIPE INTEGRITY TESTING 4 5 <br /> TEST FREQUENCY 0 a.ANNUALLY El b.EVERY 3 YEARS JQ c.OTHERS i h D 49 490.47 <br /> 5.VISUAL PIPE MONITORING. 49048 <br /> FREQUENCY ❑ a DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY d EACH TIME SYSTEM OPERATED' 490.49 <br /> -A mfm m9 1e a.wM Nd piping o,ly on HSC WN 1.S(W) <br /> ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(aX3)1• 4W50 <br /> 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM <br /> 490.31 <br /> 4:,52 <br /> ❑ 99.OTHER(Specify) 49053 <br /> UPCF UST-D(12/2007)1/4 <br />