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03/16/2009 HON 7: 51 FAX 209466,1433 SJC ERD Am ®001/004 <br /> ""'UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TA14K <br /> MONITORING PLAN-(Pago I of Z) <br /> 'TYPEF OACTION 0 1.NEW PLAN Gr2.CHANGE Or.INFORMATION 490-t <br /> PLAN TYPE ❑ 1.MONITORING IS IDENTICAL FOR ALL USTe AT THIS FACILITY. <br /> Check one iter only-ir-2"THIS PLAN COVERS ONLYTHE FOLLOWING UST SYSTEM(S1 <br /> �_ ____ •1. FACILITY INFORMATION _ <br /> FACILITY IDN(ARer'cy We Only) <br /> 6USINIESS NAME(Sauna as FACILITY NAME)~ <br /> BUSINESS SITE ADDRESS 10T CITY 104. <br /> IL EQUIPMENT TESTING AND PRE,VENT MAINTENANCE <br /> Posting,preventiYe maintenance,And Calibration of monitoring cquipmcill.(e.g.,sensom.probes,lino leak doteetors,etc,)must In perfomiod At the fiequency <br /> SpCei6ed by 1110 cquipmeut manufacturers'hmnietions,or annually,whicbem is morc ffecluom,and that such Work muaL be perfonned by qualified personnel. <br /> (23 CCR Q2G�2,2634,2618,2Ga ......................................._....._.. .-.._•. ....-.....,....-•--••--.................-.........................I........-- _...... <br /> -- <br /> MONITORING EQUIPMENT IS SERVICED I.ANNUALLY ❑ 99.OTHER(Specify); ; <br /> ,._.....�...:M_.,.._.._...�._�_._ _rrr.moNxTotzrN LCATIONS <br /> ❑ 1.NISW SITE PLOT PLANIMAP SUDMITTED WITH THIS PLAN. ,SITE PLOT PLAN/MAP PREVIOUSLY SUIlMirm. (23 CCR§2632, <br /> IV,TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S),,m M <br /> [� I CONTINUOUS ELI;CTRONICTANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT __•OTs <br /> VAULT(S)WITH AUDIOLE AND VISUAL ALARMS.�(2/3 CCR§2632,2634) <br /> SECONDARY CONTAINMENT IS ❑ a.DRY �1 b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 400'6 <br /> ..........---•-_..............--......................_-- <br /> ^........................ ...................................._...,............_.....I....................... <br /> PANEL MANUFACTURER. :::741GA9� 490 y, 490.8 <br /> MODELO <br /> ..................................... ......... _ �.. 1111.....V._ 1111__ <br /> _.- _^_. •-•---•--•-•------.....-..•.., <br /> LEAK SENSOR MANUFACTURER �!D' . MODEL N S): e90 10 <br /> 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S),(23 CCR§2643) 4510 n 1 <br /> PANEL MANUFACTURER; 4`'011' MODELM 4510.11 <br /> ---•-............_........--•_ - _ ___�_...........-•------------••-----•--------------------------^--..--_.................................._...---^.^_..-.................,........._..--.. .. <br /> IN-TANK PROBE MANUFACTURER: 480.14' MODELw_(_S_)_-. iwis <br /> .................................................................^_,�_ _ --_._...^..-,-........... .........,--•........ <br /> LEAK*QST'PREQU.ENCY; ❑ A.CONTINUOUS O b.DAiLYMIGHTLY -❑ c.WEEKLY _- <br /> .. --•490.14 <br /> ❑ d.MONTHLY -❑ a:OTHER(S(lecil�). . 490-17 <br /> ••......._......•.. <br /> PROGRAMMED TESTS; [I a.0.1 g•p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): 499 0.13 <br /> ❑ 3.MONTHLY STATISTICAL INV SNTORY RECONCILIATION(23 CCR§2646,1); 00.20 <br /> C) 4.%VPCKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTINO PERIOD: D a.36 HOURS (Ib.60 HOURS 4000.22 <br /> $.TANK INTEGRITY TESTING(Z3 CCR§7643.1); 490.3! <br /> TEST FREQUENCY; C1 a,ANNUALLY J_-) h.BIENNIALLY Q c.OTHER(Specify): 490-25 <br /> ❑99,OTHER (Specify): _ _ _ 490•'17 <br /> V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check nU that apply) - <br /> MISWAL <br /> 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMPS)ANDOTHER SECONDARY CONTAINMENT WITH AUDIBLE AND '190-m ALARMS, (23 CCR§2636) <br /> SECONDARY CONTAINMENT IS: DRY ❑b.LIQUID FILLED ❑o.PRESSURIZED ❑d.UNDER VACUUM 490.29 <br /> ..............................._..................................................... ....-•-......•...._._..................I-.-.........--•-•-•-•- ------........ .190.3 <br /> 1111._..__1.1_1_1 3 <br /> PANEL MANUFACTURER: �.�c v 0 , MODELN: /D <br /> -............................................................ .............................................. _.. _._._,.' - �._Cy f7-- -^. <br /> LEAK SENSOR MANUFACTURER; cam•o>/C-G��7/ _ 440-2'T.M-0.DEL N(S(:----i--�- Li.�- °'a3s <br /> ....----...--.........^.............^..-._..............11.1.............,.....1. ......•-•--•--•- --- --•-•-......-_._._.._.... <br /> PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e..TURB1NS)SHUTDOWN. a.YES ❑b.NO 40034 <br /> FAILIALVDISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490.13 <br /> 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.6 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF <br /> PRODUCT FLOW WHEN A LEAK ISDETECTED(23 CCR•§3636) .._........_ 490-36 <br /> ._.._._._�.__.._..--^...._.1111..^........................ _^-1111-........ __..-.....,............._......�-�-^-�--------------... -•--------._e.�---•• <br /> MLLDMANUE ACTURER(S: 490•)7 MODGLI)(S): 4510.35 <br /> ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINIRLY PERFORMS 3.0 g.p.n.LEAK TESTS (23 CCR§2636) 490 39 <br /> ^. .........................................................................................._...........................1.11.1.....•. 40.1. <br /> 496.40. r--11........._ _..----_.._..__.._..__•__..-•--•--1111.---11.11..-•a(lii"ii'- <br /> ELLDMANUAACTURER�S) i MODELN(S); <br /> ....._......_......- -•-^ _. •^ -----------...-•----..................._...-•------•--...•..-,..,..^............................_..............__.._............................. <br /> ..._. <br /> PROGRAMMED IN UNE LEAK TEST; Q 1.MINIMUM MONTHLY 0,2 g.p.h. ❑ 2.MINIMUM ANNUAL0.1 g.p.h. 490.42 <br /> ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490•43 <br /> ELLD FAILURFJDISCONNECTION TRIGGERS AUTOMATIC PUMP SI1UTDOWN, 0 a.YES ❑b.NO 9510.44 <br /> 4.PIPE INTEGIUTY TES G 490.45 <br /> TESTFREGUENCY " n.ANNUALLY ❑ b.EV[RY 3 YEARS ❑ *.OTHER(S ccif) 4M46 400-47 <br /> 5.VISUAL PIPE MONITORING. •190.48 <br /> FREQUENCY 0 a.DAILY ❑ b.WEEKLY ❑e.MIN.MON'fI1LY R LIACHTIMESYS'T6M OPI:RATff)° 490-49 <br /> •Afb'Kd for in9n60• 91uMhn4irAt 9nC nc •ipomor fuel pilft only MSC al361, a <br /> [I 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(a)(3)I. -Imso <br /> ❑ 7.NO REGULATED PIPING PER fil;Al TH AND SAFETY CODE,DIVISION 20,CHAPTLrR 6.715 CONNECTED TO THE TANK SYSTEM <br /> 490.51 <br /> ® 99,OTHER(Specify) 490 S! <br /> UPCF USI'-D(11/1007)1/4 <br /> � 'd tSLO '°N OW6 60H }�o <br />