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U IED PROGRAM CONSOLIDATED FOR UNDERGROUND STORAGE TANK MONITORING PLAN- (Page 1 of 2) TYPE OP ACTION ❑ I.NEW PLAN ® 2.CHANGE OF INFORMATION 490-1. PLAN TYPE ® L MONITORING IS IDENTICAL FOR ALL USTS AT THIS FACILITY. 490-2. (Check are item ord)) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION FACILITY ID#(Agency Use Onl)) 1. BUSINESS NAME(Same as Facility Name or DBA) Raley's Aisle 1 #356 3 BUSINESS SITE ADDRESS 4219 Morada Lane 103' CITY Stockton 104. II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing,preventive maintenance,end calibration of monitoring equipment(e.g,sensors,probes,line leak detectors,etc.)must be performed at the frequency specified btdhice m meat manu acturersmstmcuons,or mmually,t_vhicheveris more frequent Such work must be 3(_errorn3ed6r�qualifi�ersonnel.I'-3 ccR§2632.2634,z63s,,zs4�L MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY ❑ 99.OTHER(Specify): 49o-34. 490.36. III. MONITORING LOCATIONS ❑ 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN N 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED [23 CCR§2632,2634] 4904' IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) I(C'= ® 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) 4905. WITH AUDIBLE AND VISUAL ALARMS.[23 OCR§2632,26341 SECONDARY CONTAINMENT 1S: ❑ a.DRY ® b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 491-6. PANELMANUFACTURER veeder root "o-7 MODEL#: TLS 350 R 4908. LEAK SENSOR MANUFACTURER: veeder root 400.9. MODEL#(S): 303 49x10. 2.AUTOMATIC TANK GAUdNG(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANKS) [23 cert§264ij PA,NELMANUFACTURER: 400-12. MODEL#: 49D-13. IN-TANK PROBE MANUFACTURER 490-14_ MODEL#(S): 490-15. LEAK TEST FREQUENCY: ❑ a CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490.16. ❑ d.MONTHLY ❑ e.OTHER(Specify): 490'17. PROGRAMMED TESTS: ❑ a.0.1 h. ❑ b.0.2 h. ❑ c.OTHERS eci 490-18. ❑ 3.MONTHLY_STATISTICAL INVENTORY RECONCILIATION 123 con.§2646.11 490-20. ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)[23 cca§26453 TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 490-21. _____.__.�_. _ 49_0.22_ ❑ 5.TANK INTEGRITY TESTING PER[23 cca§2949.11 49D-23. _ _TEST FREQUENCY: 0_a.ANNUALLY ❑ b.BIENNIALLY [Ic.OTHER(Specify): 4909o-24' ❑ 99,OTHER(Specify):-- ---. .--- --- 490.26. 490-27. V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) 11aheack all ® 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 49028. 'occ SECONDARY CONTAINMENT IS: N e.DRY N b.LIQUID FILLED El c.PRESSURIZED N d.UNDER VACUUM 49029. PANEL MANUFACTURER:veeder root 490.30 MODEL#: TLS 350 R 490-31, LEAK SENSOR MANUFACTURER: Veeder root 49032. MODEL#(s): 208, 304, 466 49033. PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE-)SHUTDOWN. N a.YES ❑ b.NO 490-34, FAILUREIDISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. _ ® a.YES ❑ b.NO 490-35, --0-2.2vIECHANICAL LINE LEAK DETCCTOR(MELD)THaf ROUTINELY PBRFORMS 3.0 g.p.h. LEAK TESTS AND RGSTR]CTS OR SHUTS-OFF 4w-3a- PRODUCT FLOW WI-IEN A LEAK IS DETECTED.(23 cca§26361 MLLD MANUFACTURER(S): 490-37' MODEL 4(s): 49 39. ® 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.[23 CCR§26361 4000-2 ELLD MANUFACTURER(S):Veeder root 49040. MODEL#(S): 8484 49a4i. PROGRAMMED IN LINE LEAK TEST: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0,1 g.p.h. 49042. ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑ b.NO 99043. ELLD_FAILURE/DISCONNECTION TRIGGERS.AUTOMATIC PUMP SHUTDOWN. ® a.YES El b.NO 49044. ❑ 4.PIPE INTEGRITY TESTING------�_�__.._. 49045_ _ TEST FRE UENCY: ❑ a.ANNUALLY 49046' _ Q `0 b.EVERY 3 YEARS ❑ c,_OTHER(Specify) 490-47. ❑ 5.VISUAL PIPE MONITORING. - 49046. FREQUENCY: ❑ e.DAILY ❑ b.WEEKLY ❑ C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 49049. _____ 4 y.'Allmvedfonnonil_n8 otunburied emm cu my ecnemlor fuelpi ip ng only-Qer HSC§25281.5�3(�_T ❑ 6.SUCTION PIPBVG_MEETS EXEMPTION CRITERIA.123 OCR§2636(0)(3)1 490-90. ❑_7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM. 4051- ❑ 94.OT1-IER(Specify) -- -'--- _---- --------- ----'--------'a9asi. 490-53. UPCF UST-D(I2r2007)-It4 vvniv.unidoe6.org