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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN - (Page 1 of 3) TYPE OF ACTION ❑ 1.NEW PLAN ® 2.CHANGE OF INFORMATION 490-1 PLAN TYPE ® 1 MONITORING IS IDENTICAL FOR Al.I USTs AT THIS FACII ITY T90-2- (Check one item only) ❑ 2 IHIS PIAN COVERS ONLY THE FOLLOWING(IST SYSIEM(S): 490-2° I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) I I BUSINESS NAME(Same as Facility Name or DBA) ARCO 06080 4 BUSINESS SITE ADDRESS 85 E LOUISE AVENUE 103 BUSINESSSITECITY LATHROP 1w II. 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 bkthe a uq ipment manufacturers'instructions,or annually,whichever is more frequent.Such work must be perforrnedy qualified personnel.123 CCL§z63z,2634_26382W Il- 490-30- MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY ❑ 99.OTHER(Specify): 490-3b. III. MONITORING LOCATIONS ® I.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN ❑ 2.SITE PLOT PI,AN/MAP PREVIOUSLY SUB`4ITTED [23 CCR§2632.26341 4904 IV. TANK MONITORING IS PERFORATED USING THE FOLLOWING METHOD(S) jJoi`ckappJA I CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAUL.T(S) 490-5 WITH AUDIBLE AND VISUAL ALARMS [23 CCR§2632 26341 SECONDARY CON IAINMENI IS ❑ a DRY ® b 1.IQUTD FILLED ❑ c PRESSURIZED ❑ d UNDER VACUUM 490.6 PANEL MANUFACTURER: Veeder Root 490-7 MODEL#: TLS-350 4901$ LEAK SENSOR MANUFACIL'R-ER: Veeder Root 490.9 MODEL#(S): 794380-3 490-10 ❑ 2 AUTOMATIC TANK GAUGING(ATG)SYSTEM CSED TO MONITOR SINGLE WALL TANKS) [23 CCL§264-31 490-11 PANEL MANUFACTURER: 49112 MODEL#: 490.13 IN-IANK PROBE MANUFACTURER: 490.14 MODEL#(S): 490-15 LEAK]EST FREQUENCY: ❑ a CONTINUOUS ❑ b DAIL Y/NIGH I L Y ❑ c WEEKLY 490-16 ❑ d MONTHLY ❑ e OIHER(Specify): 490.17 PROGRAMMED IESTS: ❑ a.0.1 h b.0.2 h. ❑ c.OTHER(Specify): 490-I8 ___.--_--�-P � 8P ( P fY)�. --490-19 _ ❑ 3.MONTHLY STATISTICAL.INVENTORY RECONCILIATION[23 CCR§2646.11 490-20 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)123 CCR§26451 ]ESTING PERIOD: [Ia.36 HOURS Elb 60 HOURS 4 490-2z.22. ❑ 5 TANK INTEGRITY TESTING PER[23 CCR§264311 490-23 IESI FREQUENCY: [I a ANNUALLY Elb.BIENNIALLY El c. 490-24 OTHER(Specify)` .__...__� 490.25. ❑ 99.OTHER(Specify): - 49 490-27., V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) �jec*a" ® 1.CONTINUOUS MONITORING OF PIPEMIPING SUMP(S)AND 0.1 HER SECONDARY CON-I AINMENf WITH AUDIBLE&VISUAL ALARMS 490-28 [23 CCR SECONDARY CON IANMENI IS: M a DRY [Ib LIQUIDFILLED ❑ c.PRESSURIZED El UNDERVACUUM 490-29 §2636PANEL MANUFACTURER:Veede!Root 490-30 MODEL#: TLS-350 490-31 LEAK SENSOR MANUFACTURER: Veeder Root 490.32 MODEL#(S): 794380-323 490.33 PIPING LEAK ALARM IRIGGERS AUTOMATIC PUMP(i e,TURBINE)SHUTDOWN ® a YES ❑ b NO 490.34 FAILURE/DISCONNECIION OF IHE MONITORING SYSTEM IRIGGERS AUTOMATIC PUMP SHUI DOWN. ® a YES [Ib.NO 490-35 -.._.____...... _-.__._..._..._-._._.___.._..---.--._........._...._..-----.---------.---_._..._.._._...__ 1,6_9 ph .._..___......____.__......__..__..._-..__.._.._____..... ® 2 MECHANICAL LINE LEAK DETECTOR(MI LD)7'HP.T ROUTINELY PERFORMS 3 0 g p h LEAK TESTS AND RESTRICTS OR SHUTS OFF 490-36 PRODUCT FLOW WHEN A LEAK IS DEIECIED (23 CCR52636) MLLDMANUFACIURER(S):VaS ago-37 MODEL#(5): LD2000-� 490-38 ❑ 3 ELECTRONIC LNE LEAK DETECTOR(EI LD)THAT ROUTINELY PERFORMS 3 0&p h LEAK TESTS 123 CCR§26361 490-39 ELLDMANUFACIURER(S): 490-40 MODEL#(S): 490.41 PROGRAMMED IN LINE LEAK TEST: ❑ a MINIMUM MONTHLY 0 2 g p h ❑ b MINIMUM ANNUAL O I g p h 490-42 ELLD DEIECTION OF A PIPING LEAK IRIGGERS AUTOMATIC PUMP SHUIDOWN ❑ a YES ❑ b NO 490-43 ELLD FAILURE/DISCONNEC'IION TRIGGERS AUIOMAIIC PUMP SHUTDOWN ❑ a.YES ❑ b.NO '90.44 ❑ 4 PIPE TNT EGRII'Y'TESTING 490-45 IEST FREQUENCY: ❑ a,ANNUALLY [J b.EVERY 3 YEARS El c.01HER S eci 49046 ❑ 5.VISUAL PIPE MONITORING 490.48 FREQUENCY: ❑ a DAILY ❑ b WEEKLY ❑ c MIN.MONIHLY&EACH IIIviE SYSIEM OPERATED• 49049 _______ _ _ _ _ __ __-§2'6'3-6-(a,-)('3)'] _ eUlowed for monilorinuMuried e of unbmergency.,aeueretor Fuelpiping only�er HC25 S281 )S3) ❑ 6 SUCTION PIPING MEETS EXEMPTION CRITERIA.[-23-C"-CR- 23 CCR§2636!4x31] 490-50 ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM. 490-51 C399.OTHER(Specify) 490-52. 490-s3. Arco 06080,Belshire Environmental Services Page T of 6