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Ask UNIFIED PROGRAM CONSOLIDATED FORMW UNDERGROUND STORAGE TANK MONITORING PLAN-(page 1 of 2) TYPE OF ACTION ❑1.NEW PLAN 2.CHANGE OF INFORMATION 690'1 • PLAN TYPE 1&M 1.MONITORING IS IDENTICAL FOR ALL LISTS AT THIS FACILITY. 6902 (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(A)- I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) _ 1 BUSINESS NAME(Same as FACILITY NAME) 3. BUSINESS SITE ADDRESS �2 ; �' 103. CRY 106 IL 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 mom frequent,and that such work must be performed by qualified personnel. 23 CCR§2632,2634,2638,2641 MONITORING EQUIPMENT IS SERVICED a.1.ANNUALLY ❑ 99.OTHER(Specify): 490.34 490.3b III.MONITORING LOCATIONS '�I 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. 112.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (73 CCR§2632, 2'634 IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): -.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 49x5 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: Va.DRY ❑ b.LIQUID FILLED ❑ C.PRESSURIZED ❑d.UNDER VACUUM 49 PANEL MANUFACTURER: 1 \ 4z MODEL#: E. L. 490.3 LEAK SENSOR MANUFACTURER: f L 49°'9. MODEL#(S): 49_10 2.AUTOMATIC TANK GAUGING(ATC)SYSTEM USED TO MONITOR SINGLE WALL TANKlS).(23 CCR§2643) 49_1 i PANEL MANUFACTURER: 49_iz MODEL#: 49-13 IN-TANK PROBE MANUFACTURER: 690'16 MODEL#(S): 49-15 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 49x16 ❑ d.MONTHLY ❑ e.OTHER(Specify): 49-17 PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 gp.h. ❑ c.OTHER(Specify): 4y :9a ❑ 3.MONTHLY STATISTTCAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490¢0 • ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 49x21 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 49_23 TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 49_24 49-25 ❑99.OTHER (Specify): 49x26 490.21 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) .CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490.28 VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS:OitDRY ❑b.LIQUID FILLED [3c.PRESSURIZED ❑d.UNDER VACUUM 49-29 PANEL MANUFACTURER: .f 6903° MODEL#: PIC, 490-31 LEAK SENSOR MANUFACTURER: 490"32 MODEL#(S):-7-05- 490-33 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ❑a.YES ❑b.NO 490.34 FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49-35 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 IECTED 23 CCR 263 490.36 MLLD MANUFACTURER(S): S DET69033 MODEL#(S): OD 490'38 ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490.39 ELLD MANUFACTURER(S) 49Wa. MODEL#(S): 49_41 PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. 49 12 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49 13 ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49044 4.PIPE INTEGRITY TESTING 49015 TEST FRE UENCY a.ANNUALLY b.EVERY 3 YEARS El c.OTHERS i 49-46 49o.17 5.VISUAL PIPENITORING. 49o.0 FREQUENCY DAILY ❑ b.WEEKLY El DAILY MONTHLY R EACH TILE SYSTEM OPERATED- 49_49 m •mio foriionn of wtgidem emuamr fual pnog wy paHBC§25291.5(b)(3) ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(a)(3)l. 49_50 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 49_51 • ❑ 99.OTHER(Specify) -9052 490.51 UPCF UST-D(1212007)1/4