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" WUNIFIED PROGRAM CONSOLIDATED FORNW UNDERGROUND STORAGE TANK MONITORING PLAN-(Pae 1 of 2) TYPE OF ACTION ❑1.NEW PLAN 2.CHANGE OF INFORMATION E ` 49r PLAN TYPE ❑ 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. _ ` ;'4 (Check one item only) K 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S)-Gas Station UST's I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) _ t BUSINESS NAME(Same as FACILITY NAME) C R L L C / # 5446 3. BUSINESS SITE ADDRESS 1 4 0 3 Country Club Blvd . 103' CITY S t o c k t o n IL EQUIPMENT TEST'ING AND PREVENTIVE MAINTENANCE NT Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must 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. (23 CCR§2632,2634,2638,_2641 MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY 490-3a. ( ecAA 490-3b III.MONITORING LOCATIONS ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. I3 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 2634)4904 IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD($)t Q 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490-5 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490.6 -------------------- ------------------------------------------------------------------------------------------------------------------------------------ 490.8 PANEL MANUFACTURER: V @ @ d @ r Root 490-7. MODEL#: TLS-350,w/ISD LEAK SENSOR MANUFACTURER: Veeder Root 4919. ; MODEL#(S): 3 0 2 490-10 ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 490-11 PANEL MANUFACTURER: 490-12. MODEL#: 490-13 ------------------------------ --------- ------------------------------------------------------------ IN-TANK PROBE MANUFACTURER: 490-14._ MODEL#(S)_ 490-15- _ ------------------------------------------------------- LEAK TEST FREQUENCY: ❑ a.CONTINUOUS -•--------_________-_________-__ Q ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490-I6 ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17 -- -- -- - - -- ----------- PROGRAMMED TESTS: ❑ a.0.1 h. ❑ b.0.2 h. ❑ c.OTHERS(Specify): 490.18 g.p.h. g.p.h. ( Pe fy): 490-19 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490-20 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: Ela.36 HOURS 171b.60 HOURS 490-21 490-22 ® 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 TEST FREQUENCY: © a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 490-24 49125 ❑99.OTHER (Specify): 490-26 490-27 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) ❑■ 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-28 VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS:Ea.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM 490-29 PANEL MANUFACTURER: V e e d e r Root_ - _-� 490-30;MODEL#: TLS-350w/ISD -- 490-31 -- 490--32� � --LEAK SENSOR MANUFACTURER: Veeder Root -- #(S): 2 0 8 490-33 - ------------------------------------- - - --------------------- PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ❑a.YES ❑b.NO 490-34 FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490-35 ❑■ 2.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 IS DETECTED(23_CCR 32636) - _ - - __- - - - --- - - 490-36 MLLD MANUFACTURER(S): VMI 490-37 MODEL#(S): L D-2 0 0 0 490-38 ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490-39 ELLD MANUFACTURERS 490 40' 49041 --------------------------�)----------------------------------------------------------f MODEL#(S):----------- - -- ---------------------- ------------ PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. a9o4z ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49043 ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490.44 ■ 4.PIPE INTEGRITY TESTING 490-45 TEST FREQUENCY ® a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 49046490.47 ❑ 5.VISUAL PIPE MONITORING. 49048 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 490-49 "Allowed for monitoring of unburied emergency enerator fuel piping only per HSC§25281.5(b)(3) ' ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA[23 CCR§2636(a)(3)]. 490-s0 ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490-51 ❑ 99.OTHER(Specify) 490-11 490-53 F Mm