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UNIFIED PROGRAM CONSOLIDATED FORM
<br /> UNDERGROUND STORAGE TANK
<br /> INIONITORING PLAN -(Page I of 2)
<br /> TYPE OF AC"TION '❑ I.NEW W PLAN ❑ 2.Cl IANGE OF INFORMATION 490 1.
<br /> PLAN TYPIi V 1.MONITORING IS IDENTICAL FOR ALI.USTs AT THIS FACILITY. 4"•2•
<br /> Ccltec&rnic ihan na(p) ❑ 'l'1ItS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S):
<br /> I. FACILITY INFORMATION
<br /> FACILITY ID,(.Agency(i,eOnit) T1 I I 1 1 t•
<br /> [BUSINESS NA,\Il' u•as FrieXtY Nu1ue w DIM) 3.
<br /> BUSINESS serf;ADDRESS 143 1 CITY -�-` 101,
<br /> H. EQUI�NT TESTING AND PREVENTIVE MAINTENANCE
<br /> Testing,plcventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line Icak detectors,etc.)must he performed at the frequency specified
<br /> by the equipment mannfacuirers'insu-tictions,or annually,whichever is more frequent.Stich work must be performed by qualified perS01111e1,123 CCit 42632.2634.26.1$1.24111
<br /> MONITORING I:(?UtPMI NT IS SI RVI(:GD� 1] L ANNUALLY ❑ 99.OTIIER(Specify): 490-ib.
<br /> III. MONITORING LOCATIONS _
<br /> ❑"I.NEW Sl'I'f.-.PL(YT'I'I.AN,A•IAI,SU[3\4i,r'r[:I)Wl'rli'I'IfIS PLAN r!�2.SITE PLO"r PLAN/MAP I'REV10liSLY SUBMITTED 123CCR§2632.26341 •190 i1'
<br /> IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD (S)(cneeknu
<br /> dr
<br /> ___ at nl)plS)
<br /> 1,CONTINUOUS ELI C:TRONIC TANK MONITORING OF ANNULAR(INTERSTITIA[")SPACES)OR SECONDARY CONTAINMENT VAUCr(s) -6.3
<br /> WITI I AUDIBLE AND VISUAL Al_ARIv1S.123cca¢2632.26311
<br /> SfiCONDARY CONTAINNIENT IS: a.DRY Elb.LIQUID FILLED Elc.PRESSURIZED ❑ d.UNOER VACUUM d90.6.
<br /> PANEL MANUFAC7111RI R: 44'2' MODEL it: rf dy ' 490•x.
<br /> LEAK SI.-NSORMANUFACTURE:R: \/97eZb11r'R, MODEL#(S): 2 490.111.
<br /> ❑ 2.M1'fOMA"CIC'['ANK OAl1GINCi(ATG)SYSTEM USED TO MONITOR SINGLE tknl_I,'fANK123 crit 426x.1 190.11
<br /> PAN[.:[_,MANUFACTURE'R: JR612' MODEL.0: 4x,•13.
<br /> IN=TANK PROBE MANUFACTURER: "'M.t MODEL ti(S): 4190-15.
<br /> L•fAK TES-l"FREQUENCY: p n.CONT'INUOU'S p b.DAI_YINIGHTLY ❑ c.WEEKLY 490.1",
<br /> ❑ 41.tvIONTIILY ❑ c.(.YT'IIER(Spccify): 440'17
<br /> 490•19.PROGRA1MIA)TI::STS: a.0.1 g.p.h. ph.0,2 g.p.h, e.0'f11ER(Specify): im.to.
<br /> ❑ 3.MONTI 11.Y STATisnCAL INVENTORY It ECONCI 1.1 AT ION I'_3 crn,26sb.11 490-20.
<br /> 1,WEEKLY MANUAL TANK GAUGING(MTG)1 ct:a vt-.4.1 TFS TINE;PERIOD: p a.36 HOURS Ono-21
<br /> [] r r � � � < ❑ EJ.60 HOURS iya"22.
<br /> ❑ S.'rANK INTI*.*G( ,ry,n.,STINC;PER t2;(TIL,24u.1J 4911-23.
<br /> '1 EST FREQUENCY: 1.ANNUALLY ❑ b.IBICNNIAI_I_Y ❑ c.O'rf4[.i12(S Jccify: 00 2.4.❑ 1 { ) ,...._.-, - 4100-.5
<br /> ❑ 99.OTIIER(Spceify): 494900-27.'26..
<br /> V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) ("eckall
<br /> TT 1.CONTINUOUS MONITORING OF PIPI:/PIPING SUMPS)AND OTLIEE2 SECONDARY CONTAINMENT WIT11 AUDIBLE�C•VISUAL ALARMS. 00.7.$•
<br /> f2-ta'i SE.-ON�Dr\KY'('-0TA1NM[:N'r 1S: a.17[2x1' � 4a/•2o.
<br /> „636 \/ )❑ b.1.1QUlD PILLC.D ❑ c.I RC:SSLRlIIiD ❑ d.UNDER VACUUM
<br /> 1 ANE',I.\4ANUTr\(:'1-U 121"s R: o�� MODEL.fr. '�-•��.1 ���'v
<br /> LEAK SEiNSOR MANUFACTURER: Vee+ e cb dp.- tza'nr hIODrl_#(S): ;, xJ;� 1x1-33.
<br /> 3 ,�,y _
<br /> PIPING I"kAK ALARM T'RIOGE,16 At.il•OMATIC PUMP(i.c..TURBINE)Sllli'I1)0\4'N. E] a.Y'IiS ❑ b,NO 4'>r1'3a•
<br /> FAII"1i12E!171SCONN!'iC'I'ION OF THE MONITORING SYST ENI T'RICiGEiRS AUTOMATIC Pl;\41'SI IUl'ITX)WN. EJa.YES D b.NO 14R'3s.
<br /> Q 2.MIiClIANiCAL LINT:E.EAK DETECTOR(MLI,D)THAT ROUTINFI.Y PERFORMS 3.0 g.p.h-kFAK'TEST'S AND RESTRICTS OR SIIUTS OFF .190.36•
<br /> PRODUCT FLOW WIIfiN A I_f:AK IS DETECfl',D.P3C('R§26361
<br /> VII.11)irlr\Nll!'AC'-I'liRl.l27ti)• '�i"'i�' MOIIP.E.=:'IC)• 4y"-39'
<br /> [� 3.ELECTRONIC LINE LEAK ofiTECfOR(I:LLD)T'LIAT'ROiiT'fNI:LI'PERFORMS 3.0 g.p.h.LEAK TESTS.123 ccaf2r.t(q 4911.311
<br /> t fiL l-D MANUFACTURER(S):�}(ee' pyk ��r 2>1- 4x1-46. MODEL Y(S): 49u'u.
<br /> PROXiRAMMED IN I.JNF,1-1:::\K'TFS"!': ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ h,MINIMI.tM ANNUAL 0.1 g.p.h. 49(92•
<br /> EL.LD DETricl'ION OF A PIPING LE AK TRIGGL',12S AUTOMATIC PUMP SHUTDOWN. 'S a.YES ❑ b.NO
<br /> LE.L.I)FA[I.IiREi%DISC'ONNE("I'EON TRIG(;ERS AUTOMATIC PUMPSHU DOWN. Ka.YI.S ❑ b,NO
<br /> ❑ 4.PIPE INTC'.C;RITY T'1t1,1'hV(i.
<br /> 410-11,,
<br /> 'I'ES'I'FRl:iQU!':N('Y: ❑ a-ANNU:\ELY ❑ h.tiVF..RI'3 YEARS ❑ t:.OTHC•:R(Specify) ago,aT
<br /> ❑ i.VISUAL PIPE.MONITORING. 490-419.
<br /> FREQUENCY: p a.DAILY p b.WEEKI.Y ❑ C.hiIN..NiONTIlL.Y&FiACIl11 11iSYSTFMOffRA11:1)• '190•49
<br /> Allmnlfn 1-il mg orimMninlartk^thory x.m•nnor lbd piping only 1nrttSC 4'S28LSIF1131
<br /> ❑ 6.SUCTION mmNC;M[iETS I:XI3MPTION CR1TFRIA.123 colt§2636(a)(311
<br /> ❑ 7.NO REt iULAT'ED 1'I PING PER IIEAI:ell AND SAFE'L'Y CODE,DIVISION 20•0 lArrER 6,7 IS CONNECTED TO Ti IE TANK SYS•I'fiM. 90'51.
<br /> 490-s2 `
<br /> ❑ 99.(YPII[iR(Specify) aar•51. f
<br /> UPCF UST-D(12/2007)-114 ww•w.unidocs•org
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