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APR-16-2010 07: 1-5A FROP1: Tn:12094Ca83433 P. 1 UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUNDSTORAGETANK MONITORING PLAN- Pae I oft TYPE OF ACTION ❑ I.NEW PLAN 2 CHANGE OF INFORMATION 490.1 PLAN TYPE I MONITORING IS IDENTICAL FOR ALL USTs ATTHIS FACILITY. 490.2 Check one item only) ❑ 2.THIS PLAN COVERS ONLY TI IE FOLLOWING UST SYSTEM(S) I. FACILITY INFORMATION 71;E '7. FACILITY ID#(Agency Use Only) - - 1 BUSINESS NAME(Same as FACILITY NAME) BUSINESS SITE ADDRESSloJ CIT 104 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 1s more frequent,and that such work must be performed by qualified personnel 23 CCR§2632 2634 2638 264 1) -- - --490.3 MONITORING EQUIPMENT IS SERVICED PU 1.ANNUALLY ❑ 99 OTHER(Specify) 490.3b H1. MONITORING LOCATIONS ❑1.NEW SITE PLOT PLAN/MAP SIIRMITTED WITH THIS PLAN. W 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 2634)490-0 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 06 a.DRY [:] b.LIQUID FILLED El PRESSURIZED ❑d.UNDER VACUUM 990.6 -- -------- ----- -T__�_ _-_-----'_'"'__ ------------------------------- --- 90.9 PANEL MANUFACTURER:N r 'Ff)g2R b490. MODEL# T•� 2 =1................n9- Al 0-10 LEAK SENSOR MANUFACTURER: t_ 490-9 MODEL#(S) O- 'Y ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 990 11 490-12 MODEL#: 490-n PANEL MANUFACTURER: - --- - '• 490.14 MODEL#{S). 490.15 _ [N-TANK PROBE MANUFACTURER. __ - _--- -------- LEAK TEST FREQUENCY ❑ a.CONTINUOUS ❑ b_DAILY/NIGHTLY ❑ c.WEEKLY 990'16 490-17 _ ❑ d.MONTHLY O__e OTHER(Specify).---__-----------_----- ----- ...490.18 PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g p K ❑ c U"I'HFR(Specify)' 490-19 490.20 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD. C3 a.36 HOURS C] b 60 HOURS 490-21 490.22 490.23 ❑ 5.TANK INTEGRI'T'Y TESTING(23 CCR§2643.1): 490.24 TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.O'1'HEK(Specify): 490.25 490.26 ❑99 OTHER (Specify): 990x7 V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) I.CONTINUOUS MONITORING OF P1PFJ PIPING SUMPS)AND OTFIER SECONDARY CONTAINMENT WITH AUDIBLE AND 490.2e VISUALALARMS- (23 CCR§2636) 490-29 SECONDARY CONTAINMENT IS a.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d:UNDER VACUUM _- - --- --^- '- - i___-_______.._-_- 490-3I PANEL MANUFACTURER: !_� FD -MODEL#-TLS 3 SQ_I __ _ 490.33 LEAK SENSOK MANUFACTURER: l �p1 99°x2 MODEL#(S) fl�) 2-' y - 490 34 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ts a.YES ❑b.NO 490.35 FAILUREIDISCONNECtION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. M a YES ❑b.NO 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 23 C11:RA2634- _-__ 490 36 -------------- ------- --- 490-J. MLLD MANUFACTURERS) 490.37 MODEL#(S): L O u b ❑ 3.ELECTRONIC LINE LEAK DETEC OR(FLED)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§-- 490.10 2 63 49049 - �- -------' ----- ------ 49D•41 ------------- ELLD MANUFACTURER(S) MODEL#(S):- _-------------_--___...__ _ - - 490.42 PROGRAMMED IN LINE LEAK TEST. ❑ I MINIMUM MONTHLY 0 2 g.p.h ❑ 2.MINIMUM ANNUAL 0.1 g,p.h_ 490.43 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN, ❑a.YES ❑b.NO ELLD FAILUREMISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑b.NO 99(1.44 4.PIPE INTEGRITY TESTING 49045 490.46 490.47 TEST FRE UENCY [I a.ANNUALLY [Ib.EVERY 3 YEARS C] c.OTHERS cif a9r1d. 5.VISUAL PIPE MQNITORING. FREQUENCY a.DAILY ❑ b WEEKLY ❑c.MIN.MONTHLY dt EACH TIME SYSTEM OPERATED' 490 49 •Allowad for monao n of wbtwed error en arab'Riot momp onl er 1 TSC 252.1 5 J ❑ 6.SUCI'lON PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(x)(3)1. 49450 7,NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490-51 490.52 ❑ 99.OTHER(Specify) _ 490-53 UPCF UST-D(12/2007)1/4