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e SAN JOA I QUAWUNTY ENVIRONMENTAL HEALTH AWARTMENT UNDERGROUND STORAGE TANK MONITORING PLAN-PAGE 1 TYPE OF ACTION 1.NEW PLAN ❑ 2.CHANGE OF INFORMATION Mot. 1 PLAN TYPE MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. Moz. (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): L FACILITY INFORMATION FACILITY ID#(Agency Use Only) - - M03. FACILITY NAME FACILITY SITE ADDRESS 7 M04. _ MOS. U ST U. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE State law requires that testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)be performed in Mob m accordance with the equipment manufacturers'instructions,or annuall whichever is more frequent. Such work must be performed by qualified personnel. M07. 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 M�O ITORING IS PERFORMED USING THE FOLLOWING METHOD(S):(Check all that apply) Mlo. L✓J ►.CONTINUOUS ELECTRONIC MONITORING OF TANK ANNU (INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) SECONDARY CONTAINMENT IS: ❑ a.DRY [ff b.LIQUID FILLED ❑ c.UNDER PRESSURE _ UNDER VACUUM M11. PANEL MANUFACTURER: l4.2 C 0 M12. MODEL#: f .�.3"j-a M13. LEAK SENSOR MANUFACTURER: _ R A 4 4� M14 MODEL#(S): 3 �0 ?,[Uj MIs' 9'2.AUTOMATIC TANK GAUGING(AT SYSTEM USED TO MONITOR SINGLE WALL TAM 6(S) MODEL#: / G S �� M17. PANEL MANUFACTURER: + l lLcU M19. IN-TANK PROBE MANUFACTURER: ERGO MIB. MODEL#(S): Mzo. LEAK TEST FREQUENCY: [q'a.CONTINUOUS [Ib.DAILY/NIGHTLY ❑ c.WEEKLY M21. ❑ d.MONTHLY ❑ e.OTHER(Specify): J M22. M23. PROGRAMMED TESTS: 11a.0.1 g.p.h. E b.0.2 g.p.h. Elc.OTHER(Specify): INVENTORY RECONCILIATION C1a.MANUAL PER 23 CCR§2646 Elb.STATISTICAL PER 23 CCR§2646.1 M24. ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)PER 23 CCR§2645 TESTING PERIOD: F1 a.36 HOURS ❑ b.60 HOURS Mzs. ❑ 5.INTEGRITY TESTING PER 23 CCR§2643.1 M26. M27. TEST FREQUENCY: ❑ aa.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): VISUAL MONITORING DONE: DAILY ❑ b.WEEKLY(Requires agency approval) MzB. ❑ 99.OTHER(Specify): V. PIPE MONITORING M30. 7TORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(S)/TRENCH(ES)AND OTHER SECONDARY CONTAINMENT M31 SECONDARY CONTAINMENT IS: a.DRY C] b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM PANEL MANUFACTURER: U(� M32. MODEL#: L {ti S 3 5 M33. ��v M34. MODEL#(S): 17 G( 3 $ - Q M35 LEAK SENSOR MANUFACTURER: -� M36. WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN? �a.YES ❑ b.NO M37. WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? 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 M39 MLLD MANUFACTURER(s): M38. MODEL#(S): 2/3.ELECTRONIC LINE LEAK DETEC OR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS M41. ELLD MANUFACTURER:_V1_68 t'ki ' 1 T M40. MODEL#: M42. PROGRAMMED LINE INTEGRITY TESTS: [Ia.MINIMUM MONTHLY 0.2 g.p.h. [Ib.MINIMUM ANNUAL 0.1 g.p.h. M43. WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? YES ❑ b.NO WILL ELLD FAILURE/DISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN. YES ❑ b.NO M44. ❑ 4.INTEGRITY TESTING M45. M46. TEST FREQUENCY: Ela.ANNUALLY El b.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(6x3) ❑ 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) Mas ❑ 99.OTHER(Specify) 07/23/03 SJCEHD-d(07/03)-1/4