Laserfiche WebLink
SAti<IOAt2U;I1N COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN --PAGE I <br /> TYPE OF ACTION ❑ 1-NEW PLAN 2 CHANGE OF INFORMATION _ <br /> -----------^ ._._1112 <br /> PLAN TYPI): ❑ MONITORING IS IDENTICAL.FOR ALL USTs AT THIS FACILITY. <br /> i Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): — <br /> - I. FACILITY INFORMATION _-� <br /> FAC'Ii.FiY ID q 4Agencv b`se 0nit} <br /> AU!..i.Ci Y NAME e <br /> vin vu\,✓ e'- � � ,'"C L•'' —. ._V;1: I <br /> --- — MN CITY <br /> FAC•1I_ITY SITE ADDRESS <br /> _I_I. EQUIPMENT TESTING ANIS PREVENTIVE MAIXYLINAINUE <br /> —Saw law requires that testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,p robes,line leak detectors,etc)be perforred in f" i <br /> i lece-i aztce Nvi h the equipment manufacturers'instructions,or annually,whichever is more frequent. Such work must be performed by qualified personnel. I <br /> 1+17 <br /> MONITORINCr EQtJIPMENT IS SERVICED I ANNUALLY ❑ 99.OTHER(Specify): <br /> _ III. MONITORING LOCATIONS _ <br /> r Img monitoring pian must include a Sitc Pian showing the general tank and piping layouts anti the locations where monitoring is performed(i.e.location of each sensor. <br /> i ire leak detector,monitoring systen.control pane!,etc.). If you already have a diagram(e.g.,current UST Monitoring Site Plan from a Monitoring System Certifica ion <br /> Gonr.,hazardous Materials Business Pian man,etc.)which shows all required information include it with this plan <br /> IV. TANK MONITORING <br /> i;C>II1(?RIY4 t,"PERFORMED USING THE FOLLOWING METHOD(S):(Check all that apply) <br /> CONN INUOI IS T-AECTRONIC:MONITORING OF TANK ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAUL T(S) <br /> SECONDARYCONTAINMENT IS: FF a.DRY ❑ b.LIQUID FIiAI ED ❑ c.UNDER PRESSURE ❑ d UNDER VACUIiM va;r <br /> PANEL.MANUFACTURER: M12 MODEL#: 7— j; (�„ <br /> LEAK SENSOR MANUFACTL RER. M14 MODEL-ff(S). <br /> ❑ 2 ,AUL-OMA'TfC"TANK GAUGING(ATG)SYSTEM[tSED TO MONITOR SINGL.E WALL TANKS) C�jL} `9(;9 0 7 <br /> PANEL MANUFACTURER <br /> M:(I MODF:1.# <br /> MtRM152il:1iNJAtiK PROBE MANUFACTURER MODEL M(130: <br /> LEAK TES•I FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NiGHTLY ❑ c.WEEKLY i <br /> ❑ d.MONTHLY ❑ e.OTHER(Specify): M <br /> I <br /> PROGRAMMED TESTS: ❑ a 0 i g.p.h. ❑ b.3.2 g.p.h. ❑ c-OTHER(Specify): <br /> [ 3 1NVEN TORY RECONCILtv'LEON (: a MAN UAL PFR 23 CCR§2646 ❑ b-STATISTICAL PER 23 CCR 52646.! <br /> FKL Y OMAN AL TANK GAiJGING(M-M)PER 23 CCR§2645 <br /> TESTING PERIODr_1a 36 HOURS Elb.60 HOURS 12{ <br /> 5 Eti1T£GRI"'tY'1'1:S"TING PER 23 CCR§2643 i <br /> TI:.s'T FREQUENCY: ❑ a.ANNUALLY ❑ b BIEN'NiALLY ❑ c.OTHER(Specify): y _ <br /> VISUAL IUONi"YOKING DO WE- ❑ a.DAILY ❑ b.WEEKLY fRequires aeeacp nppmvaq <br /> 9 99 OTHER(Spcc,fy):— <br /> V. PIPE MONITORING <br /> MONITORING;S PERFORMED USING THE FOLLOWING METHOD(S)(Check all that a : Ml� <br /> Fp�Y) <br /> (? l CONTINUOUS FLECTRONiC MONiTOR[NG OF PIPING SUMP(S)/TRENCH(ES)AND OTHER SECONDARY CONTAINMENT <br /> SECONDARY CONTAINMENT iS: a.DRY M,l <br /> ❑ h.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM <br /> 1I IV ANUFACTURE'R: M32 MODEL#: � ` � M:3 <br /> 1.F AK SF.NSOR MANU'FACTU'RER: G". Mia MODEL.#(S)' <br /> WILL A PiPiNG LEAK ALARM TRIGGER AUTOMATIC PUMP(i.e,TURBINE)SHUTDOWN? a YES ❑ b. NO Mai <br /> WiLL FA OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN`? ® a.YES ❑ b.NO Ma' <br /> . 2 MECHANICAL LING LEAK DETECTOR (MLLD) THAT ROUTINELY PERFORMS 3.0 g.p,h. LEAK TESTS AND RI:STRICTS OR SHIA'S OFF <br /> PRODUCT FLOW WHEN A LEAK 11 DETECTED `` "j i t) 4- >i• f I �4,^t�� M <br /> —i �M3n <br /> MMODEL,#(S) } Msv <br /> MLLD M,'t\�FACTURF.R(s): �`��"' � �'.. c . <br /> ❑ 3 ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS .0 g.p.h.LEAK TESTS <br /> ELLD MANUFACTURER:_ M10 MODEL # _ Mal <br /> PROGRAMMED LINT:INTEGRITY TESTS ❑ a.MINIMUM MONTHLY 0,2 g.p.it ❑ b.MIN IMUM ANNEAL 0 l g p h. M32 <br /> WILL EI.I.D DETECTION OFA PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑1 b NO <br /> vu3 <br /> WILLELLDFAILURE,'DISCONN'EC'I'ION'TRIGGERAUTOMATiCP[JMPSHUTDOWN) E] a.YES ❑ b NO M4' <br /> i ❑ 4.(NTI`G*.RITY'IES'TING <br /> TEST FREQUENCY ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) MO \446 <br /> ( ] 5.VISLIAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY* ❑ c.MIN.MONTHLY&.EACH TiME SYS FEM OPF.RATFD*• Ma' <br /> " <br /> Ren-.4 res agency approval n4 Allowed for monitonng of unhuried emergency generator rue'.plpmg onk per HSC 5252M i bN 31 <br /> 5 PIPING IS SUCTION PIPING MEETING ALL REQUIREMEN'T'S FOR FXEMPTION FROM MONITORING PER 23 CCR§2636(aX3) <br /> 7 NO PRODUCT OR REMOTE FiLL PIPING IS CONNECTED TO-THE UST(s) <br /> I <br /> I Man <br /> ❑ 9q,OTHER(Saecify) <br /> �iidCFHD-d(07/03)-1,14 07/23/(3 <br />