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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN - ! e I of 2) TYPE OF ACTION ❑ 1. N%W PLAN 2- CHANGE, OFINFORMATION axa L. PLAN TYPE 1. MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 4990.2' (Check one iftm only) ❑ 2. TIES PLAN COVERS ONLY THE 1.OLLOWING LIST SYSTEM(S): 49P•2a L .TALCMi O IION : . FACILI'T'Y TD # (Agency Use Only) 1: BUSI�NES � ME(SanreaaFacSliry orDM, eetm � BUSINESS SITE ADA Sl,os• BUSINM- SITE/ CITY 114. Testing, preventive maimC7lance, and calibration of monitoring equipment (c.g•, sensors, Probes, line leak detectors, etc.) must be performed at the frequency specifiod by the equippiqnt manufacturers' instructions, or scmually, whichever is more fiaquent. Such work mast be performed by, qualified ,_••_-rCl, f73 CC-R;i2632 W4,2639 26411. MONITORING EQUIPMENT IS SERVICED 1. ANNUALLY ❑ 99, OTHFRS i 4!X}3n ( pec fy)• 490-3b ...'...' . ,: `.. •. ...' .' MLRL'�i 1.QG L\./LaiT ►7...::.. ':, .... : . 1- NEW SITE PLOT PLAINimA.P SUBMITTED WI'riI THtS PLAN ❑ 2- SITE PLOT PLAN/MAP PREVTOUSLY SUBMITTED 123 CCR §263„ 26341 a 4 TV: T MOiTQ.R11�:I THE k'4LLiDWM!� : A�t.. 1. CONTINUOUS FLECTROAIIC TANK MONITORING OF ANNUT•AR (INTERSTITIAL) SPACES) OR SECONDARYCONTAINMENT VAULT(S) 490-9. WITH AUDTBLF AND VISUAL ALARMS. (23 CCK §263$ 26341 SECONDARY CONTAINMENT IS: ❑ a. DRY Ob. LIQUID FIL T,F.D ❑ c- PRESSURIZED ❑ d. UNDER VACUUM PANEL MANUFACTURER � ENSA-9-- 491.7• MODEL #: 0 4X�R. LEAK SENSOR MAN! IFACTIIRER: 4917' MODEL %(S): 490.11. ❑ 2, AUTOMATTC TANK GAIICING (ATG) SYSTEM USED TO MONITOR SIN 123 CCR §26431 4X1 -11 - PANEL MANUFAC `rURER: 470-12' MODEL #; 490-13. IN -TAMC PROBE MANUFACTURER: 4`'I' 14MODEL #(S): 4.W15. LEAK TEST FREQUENCY: ❑ a. CONTINUOUS ❑ b. DA1LY/NIGHTLY ❑ c. WEEKLY 490-1& ❑ d. MONTHLY ❑ e. OTHER (Specify): 400-17. PROGRAMMED PESTS: Ela, 0.1 g-p.h. Q b. 0.2 g.p,h. _ [ c. OTHER (Specify): 4 490-1& ❑ 3. MONTHLY S•rAT]SnCAL IN VL'NTORY RECONCrr.TATION 123 CCR §2646.11 476'20' ❑ 4. WEEKLY MANUAL TANK GAUGING (MTG) I23 at wAsl TESTING PERIOD: ❑ a. 36 HOURS [a b. 60 HOURS 490-Z? ❑ 5, TANK INTFGRTTY TFSTTNG PER 123cat R g2r,4,3.q 49n-23 TEST FREOUENCY: ❑ a ANNUALLY b. BIENNIALLY c. OTHERS 400. " 99, S ___.. -M ' TP 4-2 ❑ ( 4X137. PfPF!;,MQGj PERFORMED U THE p(S). t .CONTINUOUS MONITORiNO OF PIPE/PIPING SUMP(S) AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE & VISUAL ALARMS. 490.28 1'§26C61 SECONDARY CONTAINMENT IS: ,Q a. DRY ❑ b. LIQUID FELLED ❑ C. PRESSURIZED ❑ d. UNDER VACUUM ' PANEL MANUFACTURER; Qc--UQ -% aIS x MODEL #: -VI-45, S -- 0 4WIl. LEAK SENSOR MANUI;ACTURFR: fir► W-21 MODEL #(S): 3 490-33. PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP (ie., TURBINE.) SHITTT)OWN. ❑ a. YES Nb- NO FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SIIUTDOWN. ❑ a. YES Q b. NO 2. MECHANICAL LINE LEAK DETECTOR (MLLD) THAT ROUTINELY PERFORMS 3.0 g.pA LEAK TESTS AND RESTRICTS OR SHUTS OFF 290-35. PRODUCT FLOW WHEN A LEAK IS DETECTED. WCCRR6361 MI.I.DMANUFACTURER(S): }�f 4111 MODEL#(S): FX `lX Q !q - IA ❑ 3. ELECTRONIC LINE LEAK DETECTOR (FTA,D) THAT ROUTINELY PfRFORMS 3.0 g.p.h. LEAK TESTS- (23 CCR§26861 4vu 39' ELLD MANUFACTURER(S): 49040. MODEL #(S): - 49041. PROGRAMMEDIN LINE LEAK TEST: ❑ a. MINIMUM MONTHLY 0.2g -P - h- Elb. MINIMUM ANNUAL 0,1 g.p.h. 490-42. ELLD DETECTION OF A PIPTNG LEAK TRIGGERS AUTOMATIC PUMP SKU TDOWN- ❑ a. YES ❑ b, NO 491-03. F.LLD FATLURI OTSCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a. YES ❑ b. NO 4M41 �... 49045. 4. PIPE INTEGRITY TESTING. 90-46. TEST FREQUENCY: a_ ANNUALLY El b, EVERY 3 YEARS ® c. OTHER (Specify) 4_9047. _.__.. _..._ © 5. VISUAL PIPE MONITORING, 4X17& FREQUENCY: ❑ a DAILY ❑ b. WEEKLY ❑ c. MIN. MONTHLY & EACH TIME SYSTEM OPERATLM4. 491-49• ❑ 6. SUCrION PIPING MU -IS EXEMPTION CRITERIA, 123 caR §263e(W)l 491.50 '9L"" ❑ 7. NO REGULATED PIPING PER HEALTH AND SAF81•Y CODE, DIVISION 20, CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTE=41 ❑ �. OTHER (Specify) LT`CF UST -D (12/Mn -1/4 www.URw0C .Org Effective 01/17/08 TTO/ L00'd SL90# OC:90 90OZ/ZZ/LO