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-y- W UNIFIED PROGRAM CONSOUDATED FORM UNDERGROUNO STORAGE TANK N(ONITOMG PLAN-(Pw Jof 2) 4W; TYPE OF ACTION 0 LNEW PLAN 0 2.CHANCE OF INFORMATION PLAN TYPE [] 1.MONITORING IS(DUNTICAL FOR ALL LISTS AT THIS FACILITY (Check orae' only) 0 2,THIS PLAN COVMS ONLY THE FOLLOWING UST SYSTEM(U- 1. IFACILM INFOP-MATION FACILITY IDff(4VXYUN0*) BUSINESS NAME(Sam a FACILITY NAME) -Ir3-7CITY 104, DUSINM SITE ADDRESS 2:?�to t�. ftm Lxxoe- . ---1- 2-- IL EQUIPMENT TESTING An PRRVENTIVE MAINTENANCE Testing,preventive MallilWalift-iifC(ilibration of monitoring oquipmortt(e.g. sensors,probes,tine leak detectors,W-)AlOt be perfbrnied at the frequency spe6rted by ft CqWPnzcnt Manukwfem'1119=1011s.or annually,whichever is more frequent,and that such work must be Wormed by qualiflod personnel. 23 CCR M32,2634.2638,1611L- 490.34 MONITORING EQUIPMENT IS SERVXCW I,ANNUALLY 99.OTHER(Specify): - - 490.3b 1H.MONITORING LOCATIONS I.NEW SITE P T PLAN/MAPSUBMITI'W (23 WITH THIS PUA-14. 0 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTW CCR§202, IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING MFTHOD(S)- IT r4UOtISELECrftONICTANKMONITORIKGOPAWUL-AK(FNTERSTMAL)SPACE(S)ORSECOrqDARYCONTAINMIEtfr VAULT(S)WITtI AUDIBLE AND VISUAL ALARM& (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: J�f a.DRY [I b.LIQUID FILLED 0 c,PRESSURIZED Q d.UNDER VACUUM PANEL MANUFACTURER: ........ MODEL d: LEAK SENSOR MANUFAC T UR ER: MODEL -7 L#(SY F1 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINQLE, I; (23 CCR§2643) 490-12. MODEL#: I....... X13 PANEL MANUFACTURER' ............. ............INTANK PROB0490,14. U,E MANUFACTL MOD U(S): ...-._...-• ,-, ''RQII.i6 LEAKTES7FREQUENCY' s.C.ONTiNUOUS 0 b.DAILY/NIGHTLY 0 c.WSFKLY 490-17 J d.MONTHLY [3 e.OTHER(Specify): PROGRAMMED TESTS: 0 a.0.1 g.p.h. 0 b.02 g.p.h. F-1 c.OTHER(Specify): -49o-19 [3 3.MONTHLY STATISTICAL 114VV-ZMRy RECONCILIATION(13 CCR§2646.1)- 77-490- 0 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2"5)- TESTING PERIOD: 0 a-36HOURS ❑ b.60 HOOPS 40042 rj 5.TANK INTEGRITY TESTING(23CCR§2C,43.1); 49)" TEST FREQUENCY- 0 a.ANNUALLY [] b.BIENNIALLY 0 c.artiFR(Specify): 400-23 - 4-90-26 El 99.OTII1191Z (Specify): -,1%17 V.PIPE MONITORING IS peRFORMEJ)USING THE FOLLOWING METHOD(S)(Check all that apply) 1.CONTINUOUS MONITORING(IT"rJFPJ PIPING SUMp(S)RRU-OTHERSECONDARY CONTAINMENT WITH AUDIBLE AND VISUAL ALARMS. (23 CCR P636) 490-20 SECONDARY CONTAINMENT 115:2fe-DRY Ob.LIQUID FILLED [:]c.PRF.SSURIZCD nd.UNDER VACUUM 4W - - ---------- 69041 S PANEL MANUFACTURER; - MO -Jr LijAKSENSOP.MANUFACTURI-li:__�--.Iad-e--x2LTr-----.-...,.....-.-,--��9!?�EL?(S)I ................. 4%34 'ff."YES Ob.NO PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(Le,TURBINE)SHU`=WN- 0-a.YfS C]b.NO 490.35 FAILuRrmst:ONNSMON OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. - T MECHANICAL LINE LEAK DETECTOR(MLLI))-fFLAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK T&W$AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED(23 CCR ....... .................... 4n36 38 VE23 t-- MLLD MANUFACTURER(S): 0 3.fLFX-1MONjC LINE L"K IMTECCOIR(FLLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TIF^1M (23CCR§2636) 4x 39 ELLD b4ANUFACTURER(S) MODEL PROGRAMMED IN LINE LEAK TEST, ❑ I MINIMUM MONTHLY O.2&p.h. 2.MINIMUM ANNUAL 0.1 gp.h. 490.43 ELLD DETr..(-nON OF A PIPING LEAK TRICOERS AUTOMATIC PUMP SHUTDOWN D a.YES 0 b.NO ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHU11)OWN. 0 41.YES El b.NO 70 4.PIP&INTEGRITY TF-MNG 490-4s 40OA6 490-47 TEST rRE UEt4CY Fla.ANNUALLY 0 b.EVERY 3 YEARS Lj cOTHER pecifl) 490-4 [3 5.VISUAL PIPE Mq`NITORING- 490,49 FREQUCNCY DAILY 0 b.WEEKLY 0 0.MIN.MONTHLY&BACH TIME SYSTEM OPERATED' M1. 8.11211. 490-50 F 7 NO REGULATED 0 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2§2636(x}(3)1-3)1. PIPING PER-tFFALTH AND SAFETY-CODE,DIVISION 20,CHAP1%A 6.7 IS CONNtqctk?D To THETA-ox-SYSTEM ] 490-51 49452 Specify) 490-53 UpCj?UST-D(1Z42007)I/4 GOO/ toold 0990# 9t:10 9002/tT/TT