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s UNIFIED PROGRAM CONSOLIDATED FORMW UNDERGROUND STORAGE TANK MONITORING PLAN-(Pate I of 2) TYPE OF ACTION ❑1.NEW PLAN ❑ 2.CHANGE OF INFORMATION 490.1 PLAN TYPE 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490-2 (Check one item only) 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEMS) I. FACH1W HODIMATION FACILITY ID#(Agency Use Only) I I I - - I BUSINESS NAME(Same as FACILITY NAME) 3. BUSINESS SITE ADDRESS I 103. CITY 0A) CA / 104 H.EQUIPMENT TESTING AND PREVENTIVE MADn7ENANCE 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 is more frequent,and that such work must be performed by qualified personnel. 23 CCR§263Z 2634 2638 2641 MONITORING EQUIPMENT IS SERVICED I.ANNUALLY ❑ 99.OTHER(Specify): a3b M.MONTFORING LOCATIONS ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. ❑2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 2634 IV.TANK MONMIMG IS PERFORMED USING=FOILOVANG METHOD(S): 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR MM )SPACE(S)OR SECONDARY CONTAINMENT 490.5 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: Wa.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 49" PANEL MANUFACTURER: 490-7. MODEL .: 490.8 LEAK SENSOR MANUFACTURER: 49x9_ MODEL#(Sr 490.10 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR ANGLE WALL TANKISI.(23 CCR§2643) 490.11 PANEL MANUFACTURER: 490.17. MODEL#: 490-13 IN-TANK PROBE MANUFACTURER: 490-14. MODEL#(S): 490-13 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 4 .16 ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17 490.18 PROGRAMMED TESTS: ❑ a.0.1 g p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): 490.19 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646-1): 490-20 [34.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2643). TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 44W22 El 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 490.24 TEST FREQUENCY: K a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 490-25 ❑99.OTHER (Specify): a�ii e V.PIPE MONFI'ORING IS PERFORMD USING ME FOUDWING METHOD(S)(Check all that apply) JA I.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 4w•n %rIkAL ALARMS. (23 CCR§2636) L. SECONDARY CONTAINMENT IS: DR ❑b.LIQUID FILLED ❑c.PRESSURIZED [3d.UNDER VACUUM 490 29 PANEL MANUFACTURER 490.30 MODEL# M S. 4 -31 LEAK SENSOR MANUFACTURER 4132 MODEL#(S): 4 490.33 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. a.YES ❑b.NO 490-34 FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. Q a.YES ❑b.NO 490-35 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g ph.LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED 23 CCR 4 -36 MLLDMANUFACTURE] (S): 437 MODEL#(S): I,,Ig490-38 ❑ 3.ELECTRONIC LINE LEAK DETECtOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g p h.LEAK TESTS (23 CCR§2636) 490-39 ELLD MANUFACTURER(S) 49040. MODEL#(S): 490-41 PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. 490.42 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49043 ELLD FAILUREMISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49044 4.PIPE INTEGRITY TWIING 4w4s TEST FRE UENCY W a.ANNUALLY b.EVERY 3 YEARS c.OTHERS i 490-46490.47 5.VISUAL PIPE MONITORING 490-Q FREQUENCY ❑ &DAILY ❑ b.WEEKLY ❑c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 490-49 •Allowed for ofuiburW emagwxy gumatm fug&jna ordy BE HSC W2111-12U3 ❑ 6.SUCTION PIPING MEETS EXEMP710N CRITERIA 123 CCR§2636(a)(3)1. 490-50 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 4.7 IS CONNECTED TO THE TANK SYSTEM a�-5t 490-52 ❑ 99.OTHER(specify) 490-53 UPCF UST-D(12/2 1/4