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MED PROGRAM CONSOLIDATED F UNDERGROUND STORAGE TANK J L S ZO12 MONITORING PLAN- Pae 1 of 2) TYPE OF ACTION El1.NEW PLAN rX 2.CHANGE OF INFORMATION 490-1. PLAN TYPE L MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. PERMIT(SERVICES 490-2. (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) 1- BUSINESS NAME Same as Facility Name or DBA) 3. BUSINESS SITE ADDRESS 101 CITY 104 IL EQUIPMENT TESTING AND PREVENTIVE MAINTENANC Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must be performcd at the frequency specified by the equipment rnanufactuttis'instructions or annually,Whichever i5 more frequent Such Work must be performed by qualified personnel.[D CCR§2632,2634,2635,26411_ 49 U, MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY ❑ 99.OTHER(Specify): 4y 3b, III. MONITORING LOCATIONS ❑ L NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN Dk2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED (D CCR§2632,2634] 490x. IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) itiaheak(o 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SEC NDARY CONTAINMENT VAULT(S) 490-5. WITH AUDIBLE AND VISUAL ALARMS.(D CCR§2632,26341 SECONDARY CONTAINMENT IS: a.DRY ❑ b.LIQUID FILLED ❑ c.PRESS IZED ❑ d.UNDER VACUUM 490-6. PANEL MANUFACTURER: \§tz QA Rogm 490-J' ODEL#: T LC lsnz °90-e. LEAK SENSOR MANUFACTURER: °9°-9. MODEL#(S): 490-10. ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TAN S .[D CCR§2643] 490-11. PANEL MANUFACTURER: 4 1z. MODEL#: 49°.13. IN-TANK PROBE MANUFACTURER: 9°-14 MODEL#(S): ago-ts. LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ .DAILY/NIGHTLY ❑ c.WEEKLY 490-16. ❑ d.MONTHLY e.OTHER(Specify): 490-17_ PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 . .h. ❑ c.OTHER(Specify): 490909-1s. ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION[D CCR§2646.1] 49n-20. E] 4.WEEKLY MANUAL TANK GAUGING(MTG)[23 CCR§2M5] STINGPERIOD: ❑ a.36 HOURS ❑ b.60 HOURS °90-z1. ago-90 ❑ 5.TANK INTEGRITY TESTING PER[D CCR§26x3,11 490-23. TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIE LY ❑ c.OTHER(Specify): 490 25. 99.OTHER(Specify): a90-2T . al V. PIPE MONITO G IS PERFO ED USING THE FOLLOWING METHOD(S) 1c atht eak ly) 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AN OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 490-28. [23 CCR SECONDARY CONTAINMENT IS: g� a DRY b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 490-29. §2636] +� PANEL MANUFACTURER: 490-3°. MODEL#: T L.S �S 1 O 49o-3r LEAK SENSOR MANUFACTURER: 490-32. MODEL#(S): L.{QQ 490-33. PIPING LEAK ALARM TRIGGERS AUTOMAT PUMP(i.e.,TURBINE)SHUTDOWN. ❑ a.}- SE o 490-34. FAILURE/DISCONNECTION OF THE MON/ RING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 690"35. 2.MECHANICAL LINE LEAK DETECTOR(ME )THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF 49036. PRODUCT FLOW WHEN A LE IS DETEC D.[23 CCR§26361 MELD MANUFACTURER(S. 490-37, MODEL#(S): 49x38. 3.ELECTRONIC LINE LEAK DETECTOR LLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.[23 CCR§26361 q 490-39. ELLD MANUFACTURER(S): - Q 490.00' MODEL#(S): V mI-1 Lh ww O 490-41. PROGRAMMED IN LINE LE E ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. 490'02 ELLD DETECTION OF A PI G LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑ b.NO 49()43. ELLD FAILURE/DISCO CTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. Ca a.YES ❑ b.NO 49()44. ❑ 4.PIPE INTEGRITY TESTIN . °9°45' 49046. TEST FREQUENCY- ❑ a.ANNUALLY b.EVERY 3 YEARS ❑ c.OTHER(Specify) 490-°3. ❑ 5.VISUAL PIPE MONIT NG. �y 49048. FREQUENCY: ❑ a.DAILY ❑ b.WEEKLY IX e.MIN.MONTHLY&EACH TIME SYSTEM OPERATED- 49049. 'AllowedfxmolFnon� 9fuuburiede_metgnc Santa fuel grynyew HSC 25251.5 J ❑ 6.SUCTION PIPINMEETS EXEMPTION CRITERIA.[D CCR§M36(#3)] 490-50. ❑ 7.NO REGULA D PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.715 CONNECTED TO THE TANK STM. 49x51. El99.OTHER(S ify) -- + 490-sz. 49090- yL UPCF UST-D(12/2007).1/4 www.uoidocs.org VQ V�