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pow'. <br />7 <br />r_7 <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTNT <br />UNDERGROUND STORAGE TANK <br />MONITORING PLAN - PAGE 1' <br />TYPE OF ACTION ❑ 1. NEW PLAN ❑ 2. CHANGE OF INFORMATION <br />1101 - <br />PLAN TYPE MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. <br />M02. <br />(Check one item only) 0 THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): <br />1.jFAC1U�Y'1NV0kMXT10N, <br />FACILITY ID 4 (Agency Use Only) <br />FACILITY NAME <br />M03. <br />FACILITY SITE ADDRESSOla CITY E> <br />M05. <br />11. EQ!4KMENT.. G1AN0.,.'FRNj'. NT WE A"TENANC"W <br />State law requires that testing, preventive maintenance, and calibration of monitoring equipment (e.g., sensors, probes, line leak detectors, etc.) be performed in <br />accordance with the equipment manufacturers' instructions, or annually, whichever is more frequent. Such work must be performed by qualified personnel. <br />MONITORING EQUIPMENT IS SERVICED 1. ANNUALLY0 99. OTHER (Spec{f}-): <br />1.107. <br />iII.MONILOR*6 <br />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 eachscm0r, <br />line leak detector, monitoring system control panel, etc.etc.}.Ifyou already have a diagram (e.g, cunxmt UST Monitoring Site Plan from a Monitoring System Certification <br />form, Hazardous Materials Business Plan map, etc.)which shows all !Mired information, include it with this plan. <br />MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): (Check all that apply) <br />Mm <br />P9,J. CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR (INTERSTITIAL) SPACE(S) OR SECONDARY CONTAINMENT VAULT(S) <br />SECONDARY CONTAINMENT IS: (0 a. DRY 0 b. LIQUID FILLED 0 c. UNDER PRESSURE 0 d. UNDER VACUUNI <br />Mll- <br />VTI <br />PANEL MANUFACTURER: F-&±> r_A- koo I 3•S12. MODEL :L L_ _C, � -5;- C) <br />M13. <br />LEAK SENSOR MANUFACTI. .1114. MODEL g(S): 4/2-4> Y 2 7 <br />MIS, <br />0 2- AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SINGLE WALL TAX'K(S) <br />PANEL MANUFACTURER: X10DEL 9: <br />M17. <br />IN -TANK PROBE MANUFACTURER: MODEL #(S): <br />M19. <br />LEAK TEST FREQUENCY: ❑ a. CONTINUOUS 0 b. DAILY/NIGHTLY 0 c. WEEKLY <br />❑ d. MONTHLY 0 e. OTHER (Specify): 1,131, <br />PROGRAMMED TESTS: ❑ a. 0. 1 g.p.h. 0 b. 0.2 g.p.h. 0 c. OTHER (Specify): M22. <br />M23. <br />0 3. INVENTORY RECONCILIATION 0 a. MANUAL PER 23 CCR §2646 0 b. STATISTICAL PER 23 CCR §2646.1 <br />M24. <br />0 4. WEEKLY MANUAL TANK GAUGING (MTG) PER 23 CCR §2645 <br />TESTING PERIOD: 0 a. 36 HOURS ❑ b. 60 HOURS <br />M25. <br />5. INTEGRITY TESTING PER 23 CCR §2643.1 <br />TEST FREQUENCY: 47a. ANNUALLY 0 b. BIENNIALLY 0 c. OTHER (Specify): M26. <br />M27.W&VISUAL <br />MONITORING DONE: JW a. DAILY 0 b. N17EEKLY (tatui- agency oMo%,d) <br />0 99. OTHER (Specify): <br />M28, <br />V. ITE _90NITOX NiG <br />MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) <br />M30. <br />IA. I. CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(SYTRENCH(ES) AND OTHER SECONDARY CONTAINMENT <br />SECONDARY CONTAINMENT IS: [4 a. DRY 0 b. LIQUID FILLED 0 c. UNIDER PRESSURE ❑ d. UNDER VACUUM <br />M31. <br />PANEL MANUFACTURER: - �ZGEZ?f-& 9-oo-r M32. MODEL #: -1-e- S ?=5� <br />M33. <br />LEAK SENSOR MANUFACTURER: _Va4t� Xg- P-0 C.-- r- M34. MODEL #(S):- <br />M35. <br />-WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP (i.e., TURBINE) SHUTDONN NI? YES ❑ b. NO <br />M16 - <br />WILL FAILUREMISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTONLATIC PUMP SHUTDOWN? a. YES ❑ b. NO <br />M37- <br />0 2- MECHANICAL LINE LEAK DETECTOR (MLLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS <br />OFF <br />PRODUCT FLOW WHEN A LEAK IS DETECTED <br />MLLD MANUFACTU RER(s): MODEL #(S): <br />M39. <br />Ma, ELECTRONIC LINE LEAK DETECTOR (ELLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS. <br />ELLD MANUFACTURER: '%t4o- MODEL 1pL <br />M41. <br />PROGRAMMED LINE INTEGRITY TESTS: ❑ a. MINIMUM MONTHLY 0.2 g.p.h. 1% b. MMI \IUM ANNUAL 0.1 g.p.h. <br />16142. <br />WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN?M43- <br />10a.YLS n b. NO <br />WILL ELLD ]�AIL SCONNECTION TRIGGER AUTOjjAnC pUMp sHUTDO\%ff? a.YES Ob. NO <br />M44 - <br />M -4. INTEGRITY TESTING <br />TEST FREQUENCY: 91 a, ANNUALLY 0 b. EVERY 3 YEARS 0 c. OTHER (Specify) M45. <br />M46. <br />0 5.VISUAL MONITORING DONE: Ig a. DAILY 0 b. WEEKLY* [I c. MN. MONTHLY & EACH TIME SYSTEM OPERATED** <br />m47. <br />* fteq-- Arnq OFF -d - Allowed Rvinonkorino ofunburied eole%ency g-- fiml pping "y per HSC §25n_l.*)(3) <br />116. PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXEMPTION FROM MONTITORING PER 23 CCR §206(aX3) <br />0 7. NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) <br />❑ 99. OTHER (Specify) <br />M4& <br />SJCEHD-d (07/03) - 114 <br />