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UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN-(Pae 1 of 2) <br /> TYPE OF ACTION ❑ 1.NEW PLAN ® 2.CHANGE OF INFORMATION 490-1 <br /> PLAN TYPE ® 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490-2 <br /> (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): <br /> I. FACILITY INFORMATION <br /> FACILITY ID#(Agency Use Only) I <br /> BUSINESS NAME(Same as FACILITY NAME)ARCO 06080 3. <br /> BUSINESS SITE ADDRESS 85 E LOUISE AVE 103• c1TY LATHROP 104. <br /> IL EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE <br /> Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must be performed at the frequency <br /> specified by the equipment manufacturers'instructions,or annually,whichever is more frequent,and that such work must be performed by qualified personnel. <br /> (23 CCR§2632,2634,2638,264 1) <br /> ----------------------------------------------------------------------------------------------------------------------------------------- <br /> MONITORING EQUIPMENT IS SERVICED ® L ANNUALLY ❑ 99.OTHER(Specify): 4990-3b <br /> III.MONITORING LOCATIONS <br /> ®1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. [12.SITE PLOT PLANMAP PREVIOUSLY SUBMITTED. (23 CCR§2632, <br /> 2634)490-4 <br /> IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): <br /> ® L CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490-5 <br /> VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) <br /> SECONDARY CONTAINMENT IS: ❑ a.DRY ® b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490-6 <br /> - - -- - ----- - - - --- -- - - - - - - - ------ ._- ---_ __- - - - - - - ---- <br /> - --- PANEL MANUFACTURER: VEEDER ROOT------_- --- - 490.7-! MODEL#: TLS-350 490-8 <br /> 490. <br /> LEAK SENSOR MANUFACTURER: VEEDER ROOT MODEL#(S): 794380-303 <br /> -- - -- --- -___- - --0-10 <br /> 490-9. 10 <br /> ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 490.11 <br /> PANEL MANUFACTURER: 490-12. MODEL#: 490-13 <br /> --- -- -_-_-_- - _--_-- - ----- - - ----- - - -- ----------------------------- -- ------ <br /> IN-TANK PROBE MANUFACTURER: 490-14. MODEL#(S): 490.15 <br /> ------------------------------------------------------------------------------------------------------------------------- <br /> LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490.16 <br /> ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17 <br /> ------------------------------------ --- - - --------------- - --- - ---------- - - - ---------- <br /> PROGRAMMED TESTS: ❑ a.0.1 h. ❑ b.0.2 h. ❑ c.OTHER(Specify): 490-19 <br /> g•P• g•P• °90-19 <br /> ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490-20 <br /> ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 490-21 <br /> 490-22 <br /> ❑ 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490.23 <br /> TEST FREQUENCY: Ela.ANNUALLY [Ib.BIENNIALLY [I <br /> c.OTHER(Specify): 490-24 <br /> ago-zs <br /> ❑99.OTHER (Specify): 490-26 <br /> ago-z7 <br /> V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) <br /> ® L CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-28 <br /> VISUAL ALARMS. (23 CCR§2636) <br /> SECONDARY CONTAINMENT IS:.Ela.DRY ®b.LIQUIDFILLED [:]c.PRESSURIZED ®d.UNDER VACWM 490-29 <br /> PANEL MANUFACTURER:VEEDER ROOT <br /> - -- - -- ------------ <br /> ------SECONDARY <br /> 490.32 go-3o j"MODEL#: TLS-350 -- - 490-31 <br /> LEAK SENSOR MANUFACTURER: VEEDER ROOT 3 MODEL#(S): 794380-323 490.33 <br /> ----------------------------------------------------------------------------------------- -----`----------- -------------------------- <br /> PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ®a.YES ❑b.NO 490-34 <br /> FAILUREIDISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ®a.YES ❑b.NO 490-35 <br /> ❑ 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF <br /> --PRODUCT FLOW WHEN A LEAK IS DETECTED(23 __ ______________-------------------------_-__-_ 490-36 <br /> MLLD MANUFACTURER(S): 490.37 MODEL#(S): 490-38 <br /> ® 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490-39-----_--_------------------------------------------------------------- 490-0-o. I <br /> ELLD MANUFACTURER(S): VEEDER ROOT MODEL#(S): PLLD 0-90-41 <br /> PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.l g.p.h. 490-42 <br /> ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ®a.YES ❑b.NO 490.43 <br /> ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ®a.YES ❑b.NO 490-44 <br /> 4.PIPE INTEGRITY TESTING 490.45 <br /> TEST FREQUENCY ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 490-46 490.47 <br /> ❑ 5.VISUAL PIPE MONITORING. 490-49 <br /> FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 490-49 <br /> *Allowed for monitoring of unburied emffgemy gemmor fuel piping only er HSC&25281.5(b)(3) <br /> ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA[23 CCR§2636(a)(3)]. 490.50 <br /> El 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM <br /> 490-51 <br /> 490-5z <br /> ❑ 99.OTHER(Specify) 490-53 <br /> Arco 06080,Belshire Environfnental Services <br />