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SAN JOAQ_dMVOUNTY ENVIRI.),NMENTAL HEALTIN&PARTMENT UNDERGROUND STORAGE TANK o MONITORING PLAN- PAGE 1 M01. TYPE OF ACTION ❑ 1.NEW PLAN ❑ 2.CHANGE OF INFORMATION JUN M02. PLAN TYPE ® MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FAINFO CILITY 12111 IO".N IT/ ` ; FACILITY ID#(Agency Use Only) M03. FACILITY NAME D.S.S. C M04 M05. FACILITY SITE ADDRESS 655 West Clay St. CITY Stockton II. 'EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE State law requires that testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors probes,line leak detectors,etc.)be performed in Mob accordance with the equipment manufacturers'instructions,or annually,whichever is more frequent. Such work must be performed by qualified personnel. Mol. MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY ❑ 99.OTHER(Specify): . .: III. MONITORING:LOGATIONS ,; :. This monitoring plan must include a Site Plan showing the general tank and piping layouts and the locations where monitoring is performed(i.e.,location of each sensor, line leak detector,monitoring system control panel,etc.). If you already have a diagram(e.g.,current UST Monitoring Site Plan from a Monitoring System Certification form,Hazardous Materials Business Plan map,etc.)which shows all required information,include it with this plan. IV. TANK MONITORING MIO. ONITORING IS PERFORMED USING THE FOLLOWING METHOD(S):(Check all that apply) 1.CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) ntl 1 SECONDARY CONTAINMENT IS: ® a.DRY ❑ b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM M13 M12. MODEL#: ILS - "3000 PANEL MANUFACTURER: Veeder - Root M15. M14. MODEL#(S): 794'390 - 408 LEAK SENSOR MANUFACTURER: IPerTer - Rnnt - ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TA MK(Sl MIT PANEL MANUFACTURER: MODEL#: M18 MODEL#(S): M19. IN-TANK PROBE MANUFACTURER: M2o LEAK TEST FREQUENCY: Ela.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY OTHER(Specify): M21. [Ie. d.MONTHLY ❑ ( P fY)� M22. M23.PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g.p.h. 11c.OTHER(Specify): AA24. ❑ 3.INVENTORY RECONCILIATION ❑ a.MANUAL PER 23 CCR§2646 ❑ b.STATISTICAL PER 23 CCR§2646.1 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)PER 23 CCR§2645 M25 TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS ❑ 5.INTEGRITY TESTING PER 23 CCR§2643.1 M26 M27 TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): ❑ 6.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(Requires agency approval) M28 ❑ 99.OTHER(Specify): V. PIPE MONITORING ONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) 1.CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(S)/TRENCH(ES)AND OTHER SECONDARY CONTAINMENT M31 SECONDARY CONTAINMENT IS: Ela.DRY El b.LIQUID FILLED ❑ c.UNDER PRESSURE El d.UNDER VACUUM M33. M32. MODEL#: TTS *3nnr PANEL MANUFACTURER: V edPr - Root Mas Mia. MODEL 794190 - 209 LEAK SENSOR MANUFACTURER: Veed�Root - M36. WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN? [R a.YES ❑ b.NO M37. WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? fR a.YES [:] b.NO 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 M38 MODEL#(S): X00, T.T17000 M39. MLLD MANUFACTURER(s): VMT ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS Mao. MODEL#: Mat. ELLD MANUFACTURER: M42. PROGRAMMED LINE INTEGRITY TESTS: Ela.MINIMUM MONTHLY 0.2 g.p.h. [I b.MINIMUM ANNUAL 0.1 g.p.h. M43. WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? C] a.YES [:1b.NO WILL ELLD FAILURE/DISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO Maa. ❑ 4.INTEGRITY TESTING Mas. Mab. TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 5.VISUAL MONITORING DONE: ® a.DAILY .Requires ab.gencyapproval •+Allowed KLY* ❑for vwn oc. �nng ofOunburied emNTHLY ergenry generEACH IMator fuel piping oE SYSTEM OnlypeHSC§D25281.5(bX3) ❑ 6.PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXEMPTION FROM MONITORING PER 23 CCR§2636(a)(3) ❑ 7.NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) Mag ❑ 99.OTHER(Specify) 07/23/03 SJCEHD-d(07/03)-1/4