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hwfwrc-d (9/24/04) -1/4 UNDERGROUND STORAGE TANK MONMRING PLAN - PAGE 1 TYPE OF ACTION El 1. NEW PLAN ® 2. CHANGE OF INFORMATION Mol' PLAN TYPE ® MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. M02. (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): T; PA+�T�ITV i' S FOR1bIATION FACILITY ID # (Agency Use Only) ., BUSINESS NAME (Same as FACILITY NAME) Shell & Milli Mart 136186 M03. BUSINESS SITE ADDRESS 3725 Tracy Boulevard M04• CITY Tracy mos. I;I., E��TIPIVI�N'I��'E�TtiYG P1NVT`�E TRNAN6r".I�rw-:-s.. - State law requires that testing, preventive maintenance and calibration of monitoring equipment (e.g., sensors, probes, line leak detectors, etc.) 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. MONITORING EQUIPMENT IS SERVICED ® 1. ANNUALLY Mob. ❑ 99. OTHER (Specify): Mol. This monitoring plan must include a Site Plan showing the general tank and piping layouts and the Dations where monitoring is performed (i.e., location of each sensor, line leak detector, monitoring system control panel, etc.). If you already have a diagram (e.g., current UST Monitoring Site Plan from a Monitoring System Certification form, Hazardous Materials Business Plan map,etc.) which shows all required information include it with this plan. -AV.-TO]d�i MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): (Check all that apply) Mlo. ® 1. CON'T'INUOUS ELECTRONIC MONITORING OF TANK ANNULAR (INTERSTITIAL) SPACE(S) OR SECONDARY CONTAINMENT VAULT(S) SECONDARY CONTAINMENT IS: ❑ a DRY ® b. LIQUID FILLED ❑ c. PRESSURIZED ❑ d. VACUUM MI i. PANEL MANUFACTURER Veeder Root M12. MODEL M TLS-35OR M13' LEAK SENSOR MANUFACTURER Veeder Root MI4. MODEL #(S): 794380-301 MIS. ❑ 2. AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SINGLE WALL TANK(S) PANEL MANUFACTURER M'6• 'MODEL #: MM IN-TANK PROBE MANUFACTURER: MIB. MODEL #(S): M19. LEAK TEST FREQUENCY: ® a. CONTINUOUS ❑ b. DAILY/NIGHTLY ❑ c. WEEKLY M2o' ❑ d. MONTHLY ❑ e. OTHER (Specify): M21• PROGRAMMED TESTS: ❑ S. 0.1 g.p.h. ® b. 0.2 g.p.h. ❑ c. OTHER (Specify): M• Mai ❑ 3. INVENTORY RECONCILIATION ❑ a MANUAL PER 23 CCR §2646 ❑ b. STATISTICAL PER 23 CCR §2646.1 M24• ❑ 4. WEEKLY MANUAL TANK GAUGING (MTG) PER 23 CCR §2645 TESTING PERIOD: ❑ a. 36 HOURS ❑ b. 60 HOURS Mu' ❑ 5. INTEGRITY TESTING PER 23 CCR §2643.1 TEST FREQUENCY: ❑ a ANNUALLY ❑ b. BIENNIALLY ❑ c. OTHER (Specify): M26. Mal ❑ 6.VISUAL MONITORING DONE: ❑ a DAILY ❑ b. WEEKLY (Requires agency app-9 ❑ 99. OTHER (Specify): NUB' •:' ,,.... _ :.:, > .. .-.-_ .iR � � ,s y�,<s ,� a �<„ "�' MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) M30. ® 1. CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(S)/rRENCH(ES) AND OTHER SECONDARY CONTAINMENT SECONDARY CONTAINMENT IS: ® a DRY ❑ b. LIQUID FILLED ❑ c. PRESSURIZED ❑ d. VACUUM M31. PANEL MANUFACTURER: Veeder Root M31 MODEL #: TLS-3508 M33. LEAK SENSOR MANUFACTURER: Veeder Root M34• MODEL #(S): 794380-352 Mas' WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP (i.e., TURBINE) SHUTDOWN? ® a YES ❑ b. NO M36. WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ® a. YES ❑ b. NO M37. ❑ 2. MECHANICAL LINE LEAK DETECTOR (MLLD) THAT ROUTINELY PERFORMS 3.0 g.pIL LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED MLLD MANUFACTURER(s): Mag' MODEL #(S): M39• ® 3. ELECTRONIC LINE LEAK DETECTOR (ELLD) THAT ROUTINELY PERFORMS 3.0 &p1L LEAK TESTS ELLD MANUFACTURER Veeder Root M40• MODEL M 8484 M41. PROGRAMMED IN LINE TESTING: ®a MINIMUM MONTHLY 02 g p_h. ❑ It. MINIMUM ANNUAL 0.1 g.p h. M42- WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? ® a. YES ❑ b. NO M43' WILL ELLD FAILURE/DISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ® a. YES ❑ b. NO M44' ❑ 4. INTEGRITY TESTING TEST FREQUENCY: ❑ a ANNUALLY ❑ b. EVERY 3 YEARS ❑ c. OTHER (Specify) M45. M46. ❑ 5.VISUAL MONITORING DONE: ❑ a DAILY ❑ b. WEEKLY" ❑ c. MIN. MONTHLY & EACH TIME SYSTEM OPERATED" M47. * Requires agency approval m* Allowed for monitoring of unburied emagency generator fuel piping only per HSC §2MOU(b)(3) ❑ 6. SUCTION PIPING MEETS EXEMPTION CRITERIA PER 23 CCR §2636(a)(3) ❑ 7. NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) ❑ 99. OTHER (Specify) Mos• hwfwrc-d (9/24/04) -1/4