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i <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN - (Page 1 of 2) <br /> TYPE OF ACTION ® I.NEW PLAN ® 2.CHANGE OF INFORMATION 4941. <br /> PLAN TYPE ® 1.MONITORING IS IDENTICAL FOR ALL.USTs AT'THIS FACILITY. 490.2 <br /> (Check one item only) ❑ 2.-1-11 IS PIAN COVERS ONLY THE FOLLOWING UST SYSTEI41(S): <br /> I. FACILITY INFORMATION1�ACii,1'€Y 1D#(Agency Use Orr!}) 1. <br /> BUSINESS NAME(Saute as Facility Mame or DBA) 3. <br /> Flyers #487 <br /> BUSINESS SITE ADDRESS 103. CITY 104. <br /> 983 Moffat blvd. Manteca <br /> II. EQUIPMENT 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 specified <br /> by the equipment manufacturers'instructions,or annually,whichever is more frequent.Such work-must be performed by qualified personnel.123 CCR§2632.2634,2638.26-[11 <br /> . - -[90.34 <br /> MONITORING EQUIPNIFNT IS SERVICED ® 1_ANNUALLY ❑ 99.0'fI TER(Specify): 490-3b <br /> III. MONITORING LOCATIONS <br /> ❑ 1.NEW SITE PLOT PLANIMAP SUBMITTED WITH THIS PLAN E) 2.SITE.PIAT PLAN/MAP PREVIOUSLY SUBMITTED (23 CCR§2632,2634) <br /> 490-4 <br /> Y. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S- (Check <br /> ® 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTFRST'ITIAL)SPACE(S)Olt SECONDARY CONTAIN?VIENT VAULT(S) 490-5. <br /> WITH AUDIBLE AND VISUAL ALARMS.123 CCR§2632,26341 <br /> SECONDARY CONTAINMENT IS: ® a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 490.6. <br /> PANEL MANUFACTURER: Veeder Root 490-7. MODEL n: TLS-350 490.1. <br /> LEAK SENSOR MANUFACTURER: Veeder Root 441 MODEL#(S): 0794380-420 490L40 <br /> ❑ 2.AUTOMATIC TANK GAUGING(KI•G)SYSTEM USED TO[MONITOR SINGLE WAIL TANK(S).(23 CCR§26431 ago-t 1 <br /> PANEL NIANUFACTURE'R: 49112. 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-t2. <br /> 490-18. <br /> _ PROGRAi\,IMED TESTS: ❑ a.0.1 g:p.b. ❑ b.0.2 g.p.h. ❑ c.O'T'HER(Specify): 490.19. <br /> ❑ 3.MONTHLY STAT'[S•rICAL INVENTORY RECONCILIATION(23 CCR§2646.11 490-20_ <br /> © 4.WEEKLY MANUAL TANK GAUGING(�1TG)123 CCR§2645] TES'T'ING PERIOD: ❑ a.36 HOURS [I44 <br /> b.60 HOURS a4an. <br /> ._.. 0-22.-_....-- <br /> -•• -"' <br /> 490-21. <br /> ❑ 5.TANK INTEGRITY TESTING PER[23 CCR§2643.11 <br /> 90-24, <br /> TEST FREQUENCY: Ela.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 4- ago-25. <br /> s. <br /> ❑ <br /> 99.OTHER(Specify). - - 440-27. <br /> V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) thakIpp11 <br /> ® 1.CONTINUOUS MONITORING OF PIPUI31PING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAI.ALARMS. 490-21 <br /> 123 CcR SECONDARY CONTAINMENT IS: M a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 490,29- <br /> §26361 <br /> 90.29.§26361 <br /> PANEL MANUFACTURER:Veeder Root 490-30. NIODEL#: TLS-350 490-31. <br /> LEAK SENSOR MANUFACTURER: Veeder Root 49032. MODFL#(S): 0794380-208 490-13 <br /> PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ® a.YES ❑ b.NO d4D-34 <br /> FAILURE/DISCONNF,CTION OF THE-MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑ b.NO 490-11. <br /> ® 2.MECHANICAL LINE -1 riK DETECTOR(hILLD)THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF ago-16. <br /> PRODUCT-FLOW WHEN A LEAK IS DE'TFCTED.(23 CCR§26361 <br /> 490.37. 490•33. <br /> MLLD MANUFACTURER(S):Va orless MODEL#(S): 99LD2000 <br /> ❑ 3.ELECTRONIC LINE LEAK DETECTOR(FLLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.123 CCR§26361 490 <br /> -39 <br /> ELLD MANUFACTURER(S): 490-40. MODFL#(S): a9o.41 <br /> al <br /> PROGRAMNIF.D 1N LINE LEAK TEST: ❑ a.MINIMUM MONTHLY 0.2 g-p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. 490-42. <br /> ELLD DETECTION OF A PIPING LEAKTRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 490.43 <br /> ELLD FAILURFIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 49044. <br /> ---..._- 440-45. <br /> ❑ 4.P1PF INTEGRITY TESTING. <br /> '('EST'FREQUENCY: ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS El c.OTHER(Specify) 490-47.i6' <br /> ❑ 5.VISUAL PIPE MONITORING. 44041 <br /> FREQUENCY: ❑ a.DAILY ❑ b.WEEKLY ❑ C.\fIN.MONTHLY S EACH TIME SYSTE\I OPERATED* 440-;9 <br /> •Allowed for mmnitot' of unburied emergency generator fuel piping only per HSC§25281.5{,6x4) <br /> ❑ 6.SUCTION PIPING HEFTS EXEMPTION CRITERIA,123 CCR§2636(a)(3)] �- 490.50 <br /> -- - -_ <br /> ❑ 7.NO REGULATED PIPING PER I IEAL TH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTFD TO THE TANK SYS'I'FA,1. 490-51. <br /> --`-- --`.-. 490.52. <br /> ❑ 99.01'11FR(Specify) 490-53. <br /> UPCF UST-D(22/2007)-1/4 wivivamidocs.org <br />