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w UNDERGROU4 STORAGE TANK MONSORING PLAN R For use by Unidocs Member Agencies or where approved by your Local Jurisdiction Authority Cited. Title 23 CCR, Sections 2632(d)(1), 2634(d)(2), and 2641(h) M01. TYPE OF ACTION ❑ 1.NEW PLAN S 2.CHANGE OF INFORMATION M02. PLAN TYPE ® MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) M03, FACILITY NAME cufrW5 -Cl Moa. CITY StoCICt011 Mos. FACILITY SITE ADDRESS 713 N. El Dorado Street II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE M06. State law requires that testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)be performed in accordance with the equipment manufacturers'instructions,or annually,whichever is more frequent. Such work must be performed by qualified personnel. Mol. MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY ❑ 99.OTHER(Specify): III. MONITORING LOCATIONS 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, 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 form,Hazardous Materials Business Plan map,etc.)which shows all required information,include it with this plan. IV. TANK MONITORING MIO. MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S):(Check all that apply) S 1.CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) MI1. SECONDARY CONTAINMENT IS: ❑ a.DRY S b.LIQUID FILLED ❑ c.UNDER PRESSURE F-1 d.UNDER VACUUM M" "112 MODEL#: TLS-350 PANEL MANUFACTURER: Veeder Root MI4 M15, LEAK SENSOR MANUFACTURER: Veeder-Root MODEL#(S): 794390-409 ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TAN K(S) M17 PANEL MANUFACTURER: MODEL#: M19. Mill-IN-TANK PROBE MANUFACTURER: MODEL#(S): DAILY/NIGHTLY ❑ c.WEEKLY Mzo. LEAK TEST FREQUENCY: C] a.CONTINUOUS [Ib. M21 ❑ d.MONTHLY ❑ e.OTHER(Specify): M22. M23. PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): M24 ❑ 3.INVENTORY RECONCILIATION ❑ a.MANUAL PER 23 CCR§2646 ❑ b.STATISTICAL PER 23 CCR§2646.1 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)PER 23 CCR§2645 M25. TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS ❑ 5.INTEGRITY TESTING PER 23 CCR§2643.1 M26 121 TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): ❑ 6.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(Requires agency approval) M28. ❑ 99.OTHER(Specify): V. PIPE MONITORING M30. MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) S 1.CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(S)/TRENCH(ES)AND OTHER SECONDARY CONTAINMENT M31 SECONDARY CONTAINMENT IS: S a.DRY [I b.LIQUID FILLED ❑ c.UNDER PRESSURE E] d.UNDER VACUUM M33 PANEL MANUFACTURER:Veeder ROOt MODEL#: TLS-350 M34. 7�d�R(1-7()� M35, LEAK SENSOR MANUFACTURER: Veeder-Root MODEL#(S): � a.YES ❑ b.NO M36. WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ® M37 WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? El 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 M38 M39. MLLD MANUFACTURER(s): MODEL#(S): S 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.M4EoMODEL#: 848480-001 AK M41. ELLD MANUFACTURER:Veeder Root M42. PROGRAMMED LINE INTEGRITY TESTS: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. � a.YES ❑ b.NO M43. WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN. ® M44. WILL ELLD FAILUREIDISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? S a.YES ❑ b.NO ❑ 4.INTEGRITY TESTING M45. M46, TEST FREQUENCY: C1a.ANNUALLY [Ib.EVERY 3 YEARS El c.OTHER(Specify) ❑ 5.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY* ❑ c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED" M47. "Requires agency approval ""Allowed for monitoring of unburied emergency generator fuel piping only per HSC§25281.5(6)(3) ❑ 6.PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXEMPTION FROM MONITORING PER 23 CCR§2636(a)(3) ❑ 7.NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) M48 ❑ 99.OTHER(Specify) UN-022A-1/5 www.unidocs.org Rev.10/14/03