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r t UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN- Pae 1 of 2 TYPE.OF ACTION ❑ I.NEW PLAN N 2.CHANGE OF INFORMATION 490'1 PLAN TYPE N I.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. °90.2 (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING uf SYSTEM(S): I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) _ 1 418101 1. BUSINESS NAME(Same as Facility Nome or DBA) USA/Tesoro 68222 3 BUSINESS SITE ADDRESS 2132 Mariposa Rd. 101 CIT' Stockton ln.. II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing,preventive maintenance,aid calibration of monitoring equipment te.g..sensors,probes,line leak detectors,etc.)must be performed at the frequency specified _by die equipment manufacturers instructions,or annually,whichever is more frequent Such work must be erformed b udified penonnel. 21ceR IM3I,24x4,2438.z4n1 MONITORING EQUIPMENT IS SERVICED N I.ANNUALLY ❑ 99.OTHER(Specify): 4 3. M. MONITORING LOCATIONS ❑ i.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN N 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED 123 COR ImR,24341 IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) ("AX `u 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) °90.3 WITH AUDIBLE AND VISUAL ALARMS.(n CCR 9m3;243x) SECONDARY CONTAINMENT IS: N a.DRY ❑ b.LIQUID FILLED ® C.PRESSURIZED ❑ d.UNDER VACUUM 4a0'4 PANEL MANUFACTURER: Veeder Root 4W7 MODEL#: TLS350 d90.9' LEAK SENSOR MANUFACTURER: Ronan 490'9- MODEL#(S): LS-3 4&l0 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).In ccR 5zw31 490.31 PANEL MANUFACTURER: 490'12 MODEL#: 4°°13 IN-TANK PROBE MANUFACTURER: 49N14 MODEL#($): 490'15 LEAK TEST FREQUENCY: ❑ &CONTINUOUS ❑ b.DAILYINIGHTLY ❑ c.WEEKLY 490.14 ❑ d.MONTHLY ❑ e.OTHER(Specify): 49°17 PROGRAMMED TESTS: ❑ &0.1 SPA ❑ Is.0.2 g.p.h. ❑ C.OTHER(Specify): . 4WIS ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION In ccR g2n4.11 woad ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)In cm 124451 TESTING PERIOD: ff-.36 HOURS ❑ It.60 HOURS 40.21. ❑ 3.TANK INTEGRITY TES'1'IN(i PER in cm 463.❑ wp23. TEST FREQUENCY: 0 .ANNUALLY wo.24 REQU a - �_b.BIENNIALLY c.OTHER(Specify): 49 " ❑ 99.OTHER(specify): "...490.n 1v V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) 'C'*' aw apply) N 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMPS)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 4A0'2 123 ctst SECONDARY CONTAINMENT IS: N DRY ❑ b.LIQUID FILLED ❑ d.UNDER VACUUM 4s0'29 Izawl a" Q ❑ C.PRESSURIZED PANEL MANUFACTURER:Veeder Root i930 MODEL#: TLS350 40.31. LEAK SENSOR MANUFACTURER: Veeder Root 4M32. MODEL#(S): 794380-208 490'33 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e..TURBINE)SHUTDOWN. N &YES ❑ b.NO 490'34. FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. N a.YES ❑ b.NO 4W31 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF 49x34. PRODUCT FLOW WHEN A LEAK IS DETECTED.123 CMW361 MLLD MANUFACTURER(S)-Red Jacket 437 MOD_EL_#(ST 116-05B-$ w 38. ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.[n ccR1m3a7 w 39 ELLD MANUFACTURER(S): 49P°o MODEL#(S): 440'41 PROGRAMMED IN LINE LEAK TEST: ❑ &MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. 490.42. ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ &YES ❑ b.NO 4so'2 ELLD FAILUREIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. _ ❑ &YES ❑ b.N0 49p" ❑ 4.PIPE INTEGRITY TESTING, 49oa5 TEST FREQUENCY: ❑ &ANNUALLY ❑ It.EVERY 3 YEARS ❑ c.OTHER(Specify) x'90''6 ❑ 5.VISUAL PIPE MONITORING. V0_ FREQUENCY__ ❑ &DAILY ❑ b.WEEKLY ❑ C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED• 49x-49 'Nbwd rot na9imri9R otuobunN ens#aKy. .w W Mftonl HW 25241. l ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA.Its c I243g4R3p 49 M (3 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED"TO THE TANK SYSTEM. ❑ 99.OTHER(Specify) 690.53. i LIPCPUST-D(12R007)-V/ www.uuldon.org