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r <br /> 111A !N.MA <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN- a e 1 of 2 <br /> TYPE OF ACTION ❑ 1.NEW PLAN ® 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 or DBA) CRLLC #2705446 3 <br /> BUSINESS SITE ADDRESS 103. CITY 104. <br /> 1403 COUNTRY CLUB BLVD STOCKTON <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 equment manufacturers'instructions,or annum,whichever is more frequent_Such work must be performed bygualified personnel[23 ccR§2632,w3a,2638,26411 <br /> MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY ❑ 99.OTHER(Specify)ci 49ii-3a <br /> � 490-36. <br /> III. MONITORING LOCATIONS <br /> ❑ 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN ® 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED 123 CCR§2632,26341 4904. <br /> IV. TANK MONITORING IS PERFORMED USING FOLLOWING METHOD(S) tha( teQk t <br /> ® 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) 4- <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#: TLS-350 W/ISD 490-8. <br /> LEAK SENSOR MANUFACTURER: Veeder Root 490-9. MODEL#(S): 208 490-10. <br /> ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).[23 CCR§26431 _4961 1 I. <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 h. ❑ b.0.2 h. ❑ c.OTHERS ci 61!-18. <br /> g.p.h. g.p.h. (Specify): 4vo_>9:_....... <br /> 1111 1111...__1_111_...._ _11.11.... -... _.._.__... _. ._..__ 1.1.11_. _1111..... _1111 1111_ <br /> El3.MONTHLY STATISTICAL INVENTORY RECONCILIATION 123 CCR§2646.11 490-20. <br /> ._._........_....._...............__..........................................11_11........._.1 1111 ._.1..1.11_............. __ ..................-1111_.............. 1111.._ .._. ....... .......1111.. ............_.. .............._......... .__ 1111.. . .._ . 2..._... <br /> ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)[23 CCR§26451 TESTING PERIOD. ❑ a.36 HOURS ❑ b 60 HOURS a94§b-21. <br /> §b- <br /> ---- <br /> . 490 <br /> ..-_. <br /> ----- <br /> ❑ 5.TANK INTEGRITY TESTING PER[23 CCR§2643.11 490-23. <br /> TEST FREQUENCY: ® a.ANNUALLY El b.BIENNIALLY El c.OTHER90-24.S ci 6125. <br /> .......... _......._......... 1111.._ ....__....... ............... __1111. <br /> ❑ <br /> 99.OTHER(Specify). 0-9490 zb. <br /> 0-27. <br /> V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all <br /> that apply) <br /> ® 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 490-28. <br /> ]z3 CCR SECONDARY CONTAINMENT IS: ® a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 490-29. <br /> §2636] <br /> PANEL MANUFACTURER:Veeder Root 490-30. MODEL#: TLS-350 w/ISD 490-31. <br /> LEAK SENSOR MANUFACTURER: Veeder Root 490-32' MODEL#(S): 208 490-33. <br /> PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ❑ a.YES ❑ b.NO 490-34. <br /> FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 490-35. <br /> _......__...._....__.._.__...__....._­_____- h_--------------------..._.._.-...__...-----__..._..._-..__._.._..---�_...------...-----.._-_.-..._--.--_._.._......__..-1111-_1_111_-_--- - - <br /> ❑ 2.MECHANICAL LINE LEAK DTECTOR(MELD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF 490-36. <br /> PRODUCT FLOW WHEN A LEAK IS DETECTED.[23 CCR§26361 <br /> MLLD MANUFACTURER(S): 49031. MODEL#(S): 490-38. <br /> ._...._.... <br /> ._.....--.-...- ._......__..._-....._...__-..._ __� ..._- <br /> ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.[23 CCR§26361 490-39. <br /> ELLD MANUFACTURER(S): 490.40 MODEL#(S): 49041. <br /> PROGRAMMED IN LINE LEAK TEST: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. 49042. <br /> ELLD DET�CTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 49143. <br /> ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES [1b.NO 49044. <br /> ._._...._......__..__...-.................. <br /> 1. <br /> ❑ 4.PIPE INTEGRITY TESTING. ago as. <br /> TEST FRE UENCY: ® a.ANNUALLY Elp b.EVERY 3 YEARS ❑ 90-46.c.OTHER S eci 44 <br /> 49(1-47, <br /> Q <br /> __... ... 7. <br /> ._..__. <br /> _._........__._....__._____..___ _._-_.__._.___._....__...__...__..._-_.__.__._._..____.__,._.._._....___...__......_._,.__._.._.._............._......____._.._...---__1111---__ _ <br /> ....._...__ _. <br /> ❑ 5.VISUAL PIPE MONITORING. 49048. <br /> FREQUENCY: ❑ a.DAILY ❑ b.WEEKLY Z C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED" 49049. <br /> Allowed for monitonng of mbuned,emergency generator fuelpipmg only per_HSC§2528L5(6�3). <br /> _._........ ..._. _ ......._...... ..1111.... ...._......... ..._111.1 1111.. __._........ .-._......_...._ 1111 ........_..1 ....111.1111. ..._ ....._...._.... . . - - - <br /> ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA.123 CCR§2636(a)(3)] 490-50. <br /> ....._..._.....__111_.....__...1.-... _...__..._...._........... - <br /> ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM. ago-sti <br /> _..._...--.--....____....-----....___...........___.......__..__...._......_.__.._._.....__._._.......__................._-------...__....- -------._.._.......__...----._.._......_.....__.....__...__....._............__.._....___..__...._...._...---_.__..___...._._._....._.....---_.....__._ __. <br /> ❑ 99.OTHER(Specify) 4949-sz. <br /> 0-53. <br /> UPCF UST-D(12/2007)-1/3 www.unidoes.org <br />