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SAN JOAQU OUNTY ENVIRONMENTAL HEALTH 1 ARTMENT <br /> G UNDERGROUND STORAGE TANK <br /> �`�� MONITORING PLAN- PAGE I <br /> 0 <br /> ❑ 1.NEW PLAN ❑ 2.CHANGE OF INFORMATION Mol. <br /> ❑ MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. Moe. <br /> item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): <br /> I. FACILITY INFORMATION <br /> -ILITY ID#(Agency Use Only) - Mos. <br /> - <br /> tACILITY NAME 'e m` � I`I- �V v( L(�C <br /> v <br /> FACILITY SITE ADDRESS D g Moa. CITY �q pt f Q C� e Mos. <br /> IL EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE <br /> State law requires that testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)be performed in M06. <br /> accordance with the equipment manufacturers'instructions,or annually,whichever is more frequent. Such work must be performed by qualified personnel. <br /> MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY ❑ 99.OTHER(Specify): _D3 Mo7. <br /> III. MONITORING LOCATIONS <br /> This monitoring plan must include a Site Plan showing the general tank and piping layouts and the locations where monitoring is performed(i.e.,location of each sensor, <br /> line leak detector,monitoring system control panel,etc.). If you already have a diagram(e.g.,current UST Monitoring Site Plan from a Monitoring System Certification <br /> form,Hazardous Materials Business Plan map,etc.)which shows all required information,include it with this plan. <br /> IV. TANK MONITORING <br /> MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S):(Check all that apply) Mlo. <br /> 1.CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) <br /> SECONDARY CONTAINMENT IS: a.DRY ❑ b.LIQUID FILLED El c.UNDER PRESSURE ❑ d.UNDER VACUUM M11 <br /> PANEL MANUFACTURER: IR VPP.{GV 1ZnDT M12. MODEL#: M13. <br /> LEAK SENSOR MANUFACTURER: M14. MODEL#(S): T LS 3570 M15. <br /> ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S) <br /> PANEL MANUFACTURER: MI6. MODEL#: 2 9'�3'2D 3 0 1 M17. <br /> : M19.MODEL#(S- <br /> IN-TANK PROBE MANUFACTURER: M18. ) <br /> LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY Mzo. <br /> M21. <br /> ❑ d.MONTHLY ❑ e.OTHER(Specify): <br /> M22. M23. <br /> PROGRAMMED TESTS: Ela.0.1 g.p.h. E] b.0.2 g.p.h. ❑ c.OTHER(Specify): <br /> ❑ M24. <br /> 3.INVENTORY RECONCILIATION E] a.MANUAL PER 23 CCR§2646 ❑ b.STATISTICAL PER 23 CCR§2646.1 <br /> ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)PER 23 CCR§2645 <br /> M25. <br /> TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS <br /> ❑ 5.INTEGRITY TESTING PER 23 CCR§2643.1 <br /> M26. M27. <br /> TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): <br /> 6.VISUAL MONITORING DONE: a.DAILY ❑ b.WEEKLY(Requires agency approval) <br /> M28. <br /> ❑ 99.OTHER(Specify): <br /> V. PIPE MONITORING <br /> M30, <br /> MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) <br /> 1.CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(SyTRENCH(ES)AND OTHER SECONDARY CONTAINMENT MSI <br /> SECONDARY CONTAINMENT IS: a.DRY ❑ b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM <br /> M3z. MODEL#: Mas. <br /> PANEL MANUFACTURER: VEE 2� racz- Mss <br /> LEAK SENSOR MANUFACTURER: Mia. MODEL#(S): �1 Q s '�5�,p O$' <br /> M36 <br /> WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN? may,® a.YES ❑ b.NO <br /> WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIPjGER AUTOMATIC PUMP SHUTDOWN? a.YES ❑ b.NO <br /> M37- <br /> 2.MECHANICAL LINE LEAK DETECTOR (MLLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF <br /> PRODUCT FLOW WHEN A LEAK IS DETECTED Mss M39. <br /> MLLD MANUFACTURER(s): RED JAC-9 E-r MODEL#(S): Y <br /> ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS <br /> M <br /> M40. al. <br /> ELLD MANUFACTURER: MODEL#: <br /> Mat. <br /> PROGRAMMED LINE INTEGRITY TESTS: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. Elb.MINIMUM ANNUAL 0.1 g.p.h. <br /> 9 a.YES ❑ b.NO Mai. <br /> WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN. ❑ Mu <br /> WILL ELLD FAILURE/DISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES [Ib.NO <br /> ❑ 4.INTEGRITY TESTING Mas, M46. <br /> TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) <br /> [� 5.VISUAL MONITORING DONE: Ia.DAILY ❑ b.WEEK LY* C] c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED" M47. <br /> Requires agency approval '•Allowed for monitoring of unburied emergency generator fuel piping only per HSC§25281.5(b)(3) <br /> ❑ 6.PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXEMPTION FROM MONITORING PER 23 CCR§2636(a)(3) <br /> ❑ 7.NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) Mos <br /> ❑ 99.OTHER(Specify) <br /> 07/23/03 <br /> SJCEHD-d(07/03)-1/4 <br />