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D PROGRAM CONSOLIDATED � uUNDERGROUND STORAGE TANK D ECEN\fMONITORING PLAN- a e 1 of 2 l� 4 TYPE OF ACTION ❑ 1.NEW PLAN ® 2.CHANGE OF INFORMATION 09 90-1. 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): HEALTH I. FACILITY INFORMATION MITIS FACILITY ID#(Agency Use Only) 1 BUSINESS NAME(Same as Facility Name or DBA) Flag City Chevron 3 BUSINESS SITE ADDRESS 6421 Capitol Ave 103 CITY 95242 104 4 Lodi H. 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 fiequent.Such work must be performed by qualified personnel.[23 CCR§2632,2634,2638,26411 MONITORING E UIPMENT IS SERVICED ® 1.ANNUALLY [199.OTHERS i 490-3a. Q ( P��)� 490-3b. III. MONITORING LOCATIONS ❑ 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN ® 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED [23 CCR§2632,2634) 4904. IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Check h heck.11 10 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) 490-5. WITH AUDIBLE AND VISUAL ALARMS.[23 ccat§2632,26341 SECONDARY CONTAINMENT IS: ® a DRY ® b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 490-6. PANEL MANUFACTURER: Veeder Root 490-7. MODEL#: TLS350+ 490-9. LEAK SENSOR MANUFACTURER: Veeder Root 49"- MODEL#(s): 794380-304 490.10' 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).[23 ccR§26431 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.DAILY/NIGHTLY ❑ c.WEEKLY 490-16• ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-1T PROGRAMMED TESTS: ❑ a 0.1 h. ® b.0.2 h. ❑ c.OTHERS a90-1s. &P• g•P• (Specify): ago-19. ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION[z3 ccR§2646.1) 490-20. E] 49 4.WEEKLY MANUAL TANK GAUGING(MTG)[23 cm§2645) TESTING PERIOD: ❑ a 36 HOURS ❑ b.60 HOURS 490-21. 0.22. ® 5.TANK INTEGRITY TESTING PER 12.3 ccR§2643.1) 490-23. TEST FREQUENCY: ® a IEN ANNUALLY ❑ b.BNIALLY [Ic.OTHER(Specify): 49490-24 ❑ 99.OTHER(Specify): 490-26. 490-27. V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) "heck�ll ® 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMPS)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 490-28. [§��j SECONDARY CONTAINMENT IS: ® a DRY ❑ b.LIQUID FILLED El c.PRESSURIZED ❑ d.UNDER VACUUM 4911-29. PANEL MANUFACTURER:Veeder Root 490.30. MODEL#: TLS350 490-31. LEAK SENSOR MANUFACTURER: Veeder Root 490-32. MODEL#(S): 794380-208 490-33. PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(Le.,TURBINE)SHUTDOWN. ® a YES ❑ b.NO 490-34. FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a YES ❑ b.NO ago-35. 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF 490-36. PRODUCT FLOW WHEN A LEAK IS DETECTED.[23 cc3l§2636) q,,rn MLLD MANUFACTURER(S): AL 490-37. MODEL#(S). l-fl r+z 490-38. ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.[23 ccR§26361 490-39• ELLD N ANUFACTURER(S): 4900- MODEL#(S): 490-41. PROGRAMMED IN LINE LEAK TEST: ❑ a 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. ® a YES ❑ b.NO 490-43- ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a YES ❑ b.NO 49044. ® 4.PIPE INTEGRITY TESTING. 490-45. TEST FREQUENCY: ® a ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 4904.497 ............. ❑ 5.VISUAL PIPE MONITORING. 490-48. FREQUENCY: ® a DAILY ❑ b.WEEKLY ❑ C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED. 490.49. •Allowed for m itoring of unburied effwrgency Seneralm fuel pipin8 only per HSC§25281.5(6)(3) ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA.[23 CCR§2636(ax3)] 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) 49492. 490.53. UPCF UST-D(12/2007)-1/3 www.unidocs.org