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L UNIFIED PROGRAIM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN - (Page I of 2) TYPE OF ACTION ® I. NEW PLAN 9 2. CHANGE OF INFORMATION 490-1 PLAN TYPE ® I. MONITORING IS IDENTICAL FOR ALI. USTs AT THIS FACILITY, 490'2 (Check one heal on(j) ❑ 2. 'I'I IIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): 1. FACILITY INFORMATION FACT Lay ID # (Agency Use Only) � BUSINESS NAM F (Same as Facility Armee or DBA) 3. Flyers #487 BUSINESS SITE ADDRESS 983 Moffat Blvd. 103. CITY Manteca 104. II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing, preventive maintenance, and calibration of monitoring equipment (e.g., sensors, probes, line leak detectors, etc.) must be performed at the frequency specified h�the eyuipment manufacturers' instructions, or a_nnualiy, 3vhichever is more frequent. Such work must be performed by qualified personnel. (23 CCR §2632.2634, MONITORING EQUIPMENT IS SERVICED ® I. ANNUALLY (D99.O'fIIER (Specify): 490.34 440-3b III, MONITORING LOCATIONS ❑ 1. NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN ® 2, SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED 123 CCR§2632, 2634) 440'4 IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHODS; ►chak i MI 1. CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR (INTERSTITIAL) SPACE(S) OR SECONDARY CON'T'AINMENT VAULT(S) 440-5. WITH AUDIBLE AND VISUAL ALARMS. 123 CCR §2632,2634) SECONDARY CONTAINMENT 1S: ® a. DRY ❑ b. LIQUID FILLED ❑ c. PRESSURIZED ❑ d. UNDER VACUUM 49". PANEL MANUFACTURER: Veeder Root 490-7. MODEL #: TLS) -350 490.8. LEAK SENSOR MANUFACTURER: Veeder Root 419. MODEL #(S): 0794380-420 490-10_ _ Q 2. AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SINGLE WALT. TANK(S). (23 CCR §26431 a4o-1 E PANE[. MANUFACTURER: 440-L2 MODEL #: 490'13_ IN -TANK PROBE MANUFACTURER: 490.14. MODEL #(S): 49045 LEAK TEST FREQUENCY: ❑ a. CONTINUOUS ❑ b. DAILY/NIGHTLY ❑ c. WEEKLY 490.16. ❑ d. MONTHLY ❑ e. OTHER (Specify): 490.17. 490.18. PROGRAMME_D_TESTS: ❑ a. 0.1 g.p.h. ❑ b. 0.2 g p.h. ❑ c. OTHER (Specify): 490.19. _ ❑ 3. MONTHLY STATISTICAL, INVENTORY RECONCILIATION123CCR§2646.11 490.20. ❑ 4. WEEKLY MANUAL TANK GAUGING Iy1TG (23 Mt. §2645) TESTING PERIOD: ❑ a. 36 HOURS ❑ b. 60 HOURS y t_.. ( ) i _ _ ❑ 5. TANK INTEGRITY TESTING PER [23 CCR §2643.11 490.23. TEST FREQUENCY: ❑ a. ANNUALLY ❑ b. BIENNIALLY ❑ c. OTHER S ecif 15044. (P Y)�0.4°-2s. 490.26... ❑ 99. OTHER (Specity): 49° 27. V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Cleckall lkat a ® I. CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S) AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE & VISUAL ALARMS. 490-23 123 CCR SECONDARY CONTAINMENT IS:®a. DRY ❑ b. LIQUID FILLED ❑ c. PRESSURIZED [Id. UNDER VACUUM '40.29 §2636) PANEL MANUFACTURER: Veeder Root 440-0. MODEL#: TLS -35044031. LEAK SENSOR MANUFACTURER: Veeder Root 490.32 MODEL #(S): 0794380-208 490-33. PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP (i.e., TURBINE) SHUTDOWN. ® a. YES ❑ b. NO 440-31 FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a. YES ❑ b. NO '90-"- tD2_ MECHANICAL LING LEAK DETECTOR (hILLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF 490.36. PRODUCTFLOW WHEN A LEAK IS DFTECTED. (23 CCR§26361 MLLD MANUPACTURER(S): Vaporless -090'37' MODEL #(S): 99L.D2000 4403a. ❑ 3. ELECTRONIC LINF. LEAK DETECTOR (F LLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS. (23 CCR§26361 340.39. ELLD b• fANUFACTURER(S): 490-40.MODF(S},R 49041 PROGRAMMED IN LINE LEAK TEST: ❑ a. MINIMUM MONT I PW.a i4fJTI1M TCN � ,'.0.1 g.p.h. 49042. PUMP O 490.43 OF A PIPING LEAK TRIGGERS AUTOMATIC SHUT `' ❑ a. YES ❑ b. N ELLD DETECTION ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHU'1'DO) [Ia. YES C1b. NO 440-44. Cl 4. PITT 1NT-EGRITY TESTING. �� 490-45. '' 1t �. 490.46. TEST FREQUENCY: ❑ a. ANNUALLY ❑ b. EVERY 3 YEARS ❑ c. OTHER' peclfy) a90-47. ❑ 5. VISUAL PIPE MONITORING. 490-48 FREQUENCY: ❑ a. DAILY ❑ b. WEEKLY�tr11t= I y0. FSYST$nt OPERATED* 49D49 9m • Aifow•ed forfitabdii e_nx C: is onlyr HSC 23281.5(b)(� . - ❑ 6. SUCTION PIPING MEETS EXEMPTION CRITERIA. 123 Mt §2636(.)(3)] ° ° +90-s0 ❑ 7. NO REGULATED PIPING PER I IEALTH AND SAFETY CODE, DIVISION 20, CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM. 490.51. ❑ 99, OTHER (Specify) ago -s2. 440.33. UPCF UST -D (12/2007) -1/4 wiviv.unidocs.org