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UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK MW <br /> MONITORING PLAN- 1 oft) <br /> TYPE OF ACTION ❑1.NEW PLAN Z CHANGE OF INFORMATION 4961 <br /> PIAN TYPE .� I.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490-2 <br /> (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM( <br /> I. FACILITY INFORMATION <br /> FACILITY ID#(Agency Use Onty) 1 1 1 - 1M ' <br /> BUSINESS NAME(Same as FACILITY NAME) S RMIT/SERVICES 3 <br /> BUSINESS SITE ADDRESS Lio,5 E . 103. CITY IN. <br /> IL EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE <br /> Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)most 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 /> MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY ❑ 99.OTHER(Specify): 490-31, <br /> III.MONITORING LOCATIONS <br /> ❑1.NEW SITE PLOT PLANWAP SUBMITTED WITH THIS PLAN. 2g 2.SFFE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, <br /> 2634)4904 <br /> IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): <br /> 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490-5 <br /> VAULTS)WITH AUDIBLE AND VISUAL ALARMS (23 CCR§2632,2634) <br /> SECONDARY CONTAINMENT IS: Ea.DRY [3 b.LIQUID FILLED [I C.PRESSURIZED ❑ 90'4 <br /> E. d.UNDER VACUUM 4 <br /> PANMANUFACTURER' EED ER lW 4901. MODEL#: 7US 49041 <br /> LEAK SENSOR MANUFACTURER: VrEDEP, RwT <br /> 490-9. MODEL#(S): O a9610 <br /> ❑ 2.AUTOMATIC TANK GAUGING(ATC)SYSTEM USED TO MONITOR SINGLE WALL TANKM(23 CCR§2643) 490.11 <br /> PANEL MANUFACTURER: 49012 MODE.#: 490,13 <br /> IN-TANK PROBE_MANUFACTURER 114. MODEL#(S): --_------ -49615 <br /> -- LEAK TEST FREQUENCY: ❑ a CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY °9616 <br /> ❑ d.MONTHLY ❑ e.OTHER(Slimify): 4W17 <br /> PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 EPA ❑ c.OTHER(Specify): 499oI9 <br /> ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490,20 <br /> 0 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2644 TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 490,21 <br /> 490-22 <br /> El 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490,23 <br /> TEST FREQUENCY: [I a.ANNUALLY [Ib.BIENNIALLY [3c.OTHER(Specify): 49�o-z5 <br /> 490,z0 <br /> ❑99.OTHER (Specify): 490,27 <br /> V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) <br /> I.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-28 <br /> VISUAL ALARMS. (23 CCR§2636) <br /> SECONDARY CONTAINMENT IS:r9a.DRY ❑b.LIQU1DFILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM 490,29 <br /> PANEL MANUFACTURER: BI- 4911-30 MODEL#: 9SO 490-31 <br /> LEAK SENSOR MANUFACTURER: p£ 49032 MODEL#(S): �o __ 49x33 <br /> PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e,TURBINE)SHUTDOWN. a.YES ❑b.NO 49x34 <br /> FAI.UREMISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ®a YES ❑b.NO 490-35 <br /> 2.MECHANICAL LINE LEAK DETECTOR(MLID)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF <br /> PRODUCT FLOW WHEN A LEAK IS DETECTED 23 CCR _ 490-36 <br /> MILD MANUFACTURER(S): 490-31 MODEL#(S): 490,38 <br /> ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.ph.LEAK TESTS (23 CCR§2636) _ 490-39 <br /> ELLD MANUFACTURER(S) - _49OJ0 MODEL -- ---a9a4i <br /> E. <br /> PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. _a9oaz <br /> ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑h NO 490'43 <br /> ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490-44 <br /> 4.PIPE INTEGRITY TESTING 49 s <br /> TEST FREQUENCY a.ANNUALLY 0 b.EVERY 3 YEARS c.OTHERS 49 40,47 <br /> 5.VISUAL PIPE MONITORING. 6908 <br /> FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑c.MIN.MONTHLY&EACH TIM SYSTEM OPERATEDe 49 49 <br /> •Allowed ror ofmbuded merelor fuel pipi,,My W HSC 12521113(b)(5) <br /> ❑ &SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(a)(3))• 49 50 <br /> 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM <br /> 49051 <br /> 49032 <br /> ❑ 99.OTHER(Specify) 49x53 <br /> �IDV2dC <br /> UPCF UST-D(122007)1/4 <br /> 61-MY <br />