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'NIFIED PROGRAM CONSOLIDATED FOR! UNDERGROUND STORAGE TANK MONITORING PLAN- Page 1 of 2) TYPE OF ACTION ❑ 1.NEW PLAN ❑ 2.CHANGE OF INFORMATION 490-1 PLAN TYPE ® 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490-2 (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S)- 1. FACILITY INFORMATION FACILITY ID#(Agency Use Only) I I I - I I 11 -1 11 1 1 111 BUSINESS NAME(Same as FACILITY NAME) Safeway Fuel Station 2600-10 3' BUSINESS SITE ADDRESS 1987 W. 11 Street 103' I CITY Tracy 104. II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must be performed at the frequency specified by the equipment manufacturers'instructions,or annually,whichever is more frequent,and that such work must be performed by qualified personnel. (23 CCR X2632.2634,Zg8 2641) ------------------------------------------ -------------------- MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY ❑ 99.OTHER(Specify): 490-3 Q (Si p �')' 490-3bb III.MONITORING LOCATIONS ❑ 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. X 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 2634)490-4 IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): ® 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490-5 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: ® a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490-6 ---------------------------------------------------------------------------------------------------- -- ------------ -- - --------------------- ----- PANEL MANUFACTURER: Veeder Root TLS-350R 490-7. 7 MODEL#: 848290-012 490-8 -------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------- LEAK SENSOR MANUFACTURER: Veeder Root 490-9. MODEL#:794390-460 490-10 ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 490-11 PANEL MANUFACTURER: 490-12. MODEL#: 490-13 -- ---- - - _---- - --------------------------------------- - - -- - - - - -- -------------------------------------------- - IN-TANK PROBE MANUFACTURER: 490-14 MODEL#(S): 490-15 ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ LEAK TEST FREQUENCY: ® a.CONTINUOUS ❑ b.DAILYINIGHTLY ❑ c.WEEKLY 490-16 ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17 ------------------------- ---- - - a --- - ----- - - -- - -------------------------------------- - ---- - PROGRAMMED TESTS: ❑ 0.1 h. ❑ b.0.2 h. ❑ c.OTHERS(Specify)- 490-19 g�P• g•P• ( P y)� 490.19 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490-20 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: Ela.36 HOURS Elb.60 HOURS 490-21 490-22 ❑ 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 TEST FREQUENCY: ❑ a.ANNUALLY [Ib.BIENNIALLY [:1 c.OTHER490-24 Q (Specify)' 490-25 El99.OTHER (Specify): 490-26 490.27 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) ® 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-28 VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS:®a.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM 490-29 ---------------------------------------------------------------------------------------------------------- ------------------------------------------------------------- 490-30 490-31 PANEL MANUFACTURER: Veeder Root TLS-350 MODEL#: 848290-012 --------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------- -490-32 490-33 LEAK SENSOR MANUFACTURER: Veeder Root _MODEL#_794380.208 - -- -- -------------------------------------------------------------------------------------------------------- PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ®a.YES ❑b.NO 490-34 FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ®a.YES ❑b.NO 490-35 ❑ 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF _PRODUCT FLOW WHEN A LEAK IS DETECTED X23 CCR ------------§26361---------------------------------------------------------------------------------------- --------------- 490.36 MLLD MANUFACTURER(S): 490-37 MODEL#(S): 490-38 ® 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490-39 ELLD MANUFACTURER(S) Veeder Root0- o MODEL#(S)_ 848480-001 490-41 ---------------------------------------------------------------------------- ----------------------- PROGRAMMED IN LINE LEAK TEST: ® 1.MINIMUM MONTHLY 0.2 g.p.h. ® 2.MINIMUM ANNUAL 0.1 g.p.h. 490-42 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. X a.YES ❑b.NO 490.43 ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. X a.YES ❑b.NO 490-44 ❑ 4.PIPE INTEGRITY TESTING 49o-45 TEST FREQUENCY ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 4904649047 ❑ 5.VISUAL PIPE MONITORING. 49048 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 49049 *Allowed for Fwnitoring of unburied emergency enerator fuel piping only r HSC§25281.5(b)(3 ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA[23 CCR§2636(a)(3)]. 490-50 ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490-51 ❑ 99.OTHER(Specify) 490-52 490-53 UPCF UST-D(12/2007)1/4