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SAN JOAQtqWOUNTY ENVIRONMENTAL HEALTH DWRTMENT UNDERGROUND STORAGE TANK MONITOPJNG PLAN-PAGE 1 TYPE OF ACTION ❑ 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): FACILITY ID#.(Agency Use Only) FACILITY NAME Y e ti(-�>P �b�g��L� M03. FACILITY SITE ADDRESS L ALA M04. CITY 'L tf Mos. .f .,P. -. State law requires that testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)be performed in M06• accordance with the equipment manufacturers'instructions,or annualally�hichever is more frequent. Such work must be performed by qualified personnel. MONITORING EQUIPMENT IS.SERVICED ; 1.ANNUALLY ❑ 99.OTHER(Specify): Mm. 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 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. SIVIENNNEMBE I WIN 111 • ,. n VITORING IS.PERFORMED USING THE FOLLOWING METHOD(S):(Check all that apply) M10. .CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) � SECONDARY CONTAINMENT IS: � a.DRY [Ib.LIQUID FILLED El c.UNDER PRESSURE ❑ d.UNDER VACUUM M11. PANEL MANUFACTURER: Q.pj P-VL, i3®Ar M12. MODEL#: *`-S b M13. LEAK SENSOR MANUFACTURER: a0l) M14. MODEL#(S): Mts. ❑.2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANKS) PANEL MANUFACTURER: M16• MODEL#: MIT IN-TANK PROBE MANUFACTURER: Mls. MODEL#(S): M19. LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY Mo. ❑ d.MONTHLY ❑ e.OTHER(Specify): M21. PROGRAMMED TESTS: ❑.a.0.1 g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): M22. M23. ❑.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 M25. ❑ 5.INTEGRITY TESTING PER 23 CCR§2643.1 TEST FREQUENCY: ❑.a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): M26. M27. ❑ 6.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(Requires agency approval) ❑ 99.OTHER(Specify): M28. yr VITORING IS.PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) M30 CONTINUOUS.ELECTRONIC MONITORING?F PIPING SUMP(SyfRENCH(ES)AND OTHER SECONDARY CONTAINMENT SECONDARY CONTAINMENT IS: Ba.DRY ❑ b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM M31. PANEL MANUFACTURER: Lhajkaa, t.aavk- I t_s 3 is M32. MODEL#: TLQ 3 S:C> M33. LEAK SENSOR MANUFACTURER: M34. MODEL#(S): M35. WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN? �/tY'a.YES El b.NO M36. WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? 17 a•YES ❑ b.NO M37. M/�l.MECHANICAL LINE LEAK DETECTOR (MLLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK UDETECTED MLLD MANUFACTURER(s): t4VIP 'T(�Z�-Ct,�' M38 MODEL#(S): t-' M39. ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS.3.0 g.p.h.LEAK TESTS ELLD MANUFACTURER: Mao. MODEL#: M41. PROGRAMMED LINE INTEGRITY TESTS: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.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 **.Allowed for monitoring of unburied emergency generator fuel piping only per HSC§25281.5(b)(3) ❑ 6.PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXEMPTION FROM MONITORING PER 23 CCR§2636(a)(3) ❑ 7.NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) ❑ 99.OTHER(Specify) M48. SJCEHD-d(07/03)-1/4 07/23/03