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WF UNIFIED PROGRAM CONSOLIDATED FORNXW <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN- Pae 1 of 2) <br /> TYPE OF ACTION ❑1.NEW PLAN 91 2.CHANGE OF INFORMATION 490-1 <br /> PLAN TYPE 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490"2 <br /> (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S)- <br /> I. FACILITY INFORMATION <br /> FACILITY ID#(Agency Use Only) - = <br /> BUSINESS NAME(Same as FACILITY NAME) C, �G�( P J 3' <br /> BUSINESS SITE ADDRESS ® 1/ ® C)J( f 1°3' CITY 104' <br /> II.EQUIP TESTING AND PREVENTIVE MAINTENANCE <br /> Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must be performed at the frequency <br /> specified by the equipment manufacturers'instructions,or annually,whichever is more frequent,and that such work must be performed by qualified personnel. <br /> 23 CCR 2632 2634 2638 2641 <br /> MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY ❑ 99.OTHER(Specify): 4�3b <br /> III.MONITORING LOCATIONS <br /> ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN.g2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, <br /> 2634)o" <br /> IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): <br /> 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490-5 <br /> VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) <br /> SECONDARY CONTAINMENT IS: ❑ a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490.6 <br /> PANEL MANUFACTURER: J tcK / 0 490-7_ MODEL#: 490-8 <br /> LEAK SENSOR MANUFACTURER: 8 L 490-9' MODEL#(S): 490.10 <br /> ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 490-11 <br /> PANEL MANUFACTURER: 490-12" MODEL#: 490-13 <br /> IN-TANK PROBE MANUFACTURER: 490.14. MODEL#(S): 490-15 <br /> LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490-16 <br /> ❑ d.MONTHLY ❑ e.OTHER(Specify): 490"17 <br /> PROGRAMMED TESTS: ❑ a.0.1 g.p.h. El b.0.2 g.p.h. ❑ c.OTHER(Specify): 419 <br /> ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490-20 <br /> ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 490-21 <br /> 490.22 <br /> 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 <br /> 490-24 <br /> TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 490-25 <br /> 490.26 <br /> ❑99.OTHER (Specify): 490.27 <br /> V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) <br /> LE 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-25 <br /> ISUAL ALARMS. (23 CCR§2636) <br /> SECONDARY CONTAINMENT IS:❑a.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM 490-29 <br /> PANEL MANUFACTURER ,9 91telC Jt(/V( 11Y 490'30 MODEL#: 490-31 <br /> LEAK SENSOR MANUFACTURER 49-732 MODEL#(S): - 490-33 <br /> PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ❑a.YES ❑b.NO 490-34 <br /> FAILUREIDISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490-35 <br /> 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF <br /> PRODUCT FLOW WHEN A LEAK IS DETECTED 23 CCR 263 490-36 <br /> MLLD MANUFACTURER(S): C-_ C 190-37 MODEL#(S): 490.38 <br /> ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490-39 <br /> ELLD MANUFACTURER(S) 4"-40. MODEL#(S): 490-41 <br /> PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. 490-42 <br /> ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490-43 <br /> ELLD FAILUREIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49044 <br /> 4.PIPE INTEGRITY TESTING 49o-4s <br /> TEST FREQUENCY a.ANNUALLY b.EVERY 3 YEARS 0 c.OTHERS i 490.46490-47 <br /> 5.VISUAL PIPE MONITORING. 49048 <br /> FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 490-49 <br /> *Allmd for monitoring of wburid mWipmey gaw2W fuel piping only HSC§25281.5(W3) <br /> ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA[23 CCR§2636(a)(3)1. 490-50 <br /> 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM <br /> 490.51 <br /> 490.52 <br /> ❑ 99.OTHER(Specify) 490-53 <br /> UPCF UST-D(12/2007)1/4 <br /> l <br /> I <br />