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SAN JOA dW COUNTY ENVIRONMENTAL HEALTH BWARTMENT UNDERGROUND STORAGE TANK MONITORING PLAN-PAGE 1 M01.1 TYPE OFACTION FLNEW PLAN ❑ 2 CHANGE OF INFORMATION PLAN TYPE .MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. moz (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEMS): I. FACILITY MFOPMAUON FACILITY ID#(Agency Use Only) FACILITY NAME �_ASq (::..a FACILITY SITE ADDRESS Q-705 M03. M04- CITY M05- H. 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 M06 accordance with the equipment manufacturers'instructions,or annually,whichever is more frequent. Such work must be performed by qualified personnel. MONITORING EQUIPMENT IS SERVICED id 1.ANNUALLY 0 99.OTHER(Specify): MOT H1. MONITORING LOCATIONS 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. TAW MONITORING MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S):(Check all that apply) M10. 1.CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) SECONDARY CONTAINMENT IS: C7r a.DRY ❑ b.LIQUIDFILLED 0 c,UNDER PRESSURE r_1 A ---""-UUM M11- PANEL MANUFACTURER: 1 explRoDM12 MODEL#: -77-S 35Z M13. LEAK SENSOR MANUFACTURER: U der R.o I m14- MODEL#(S): 79q59 ti-V,)-J M15. ❑ 2 AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S) PANEL MANUFACTURER: M16. MODEL#: MIT IN-TANK PROBE MANUFACTURER: M18- MODEL#(S): M19. LEAK TEST FREQUENCY: 0 a.CONTINUOUS ❑ b.DAILY/NIGHTLY WEEKLY M20. [] d.MONTHLY ❑ Q OTHER(Specify): M21. PROGRAMMED TESTS: [I a.0.1 g.ph. ❑ b.0.2 gp.h. ❑ c.OTHER(Specify): M22 M23. 0 3.INVENTORY RECONCILIATION rl a.MANUAL PER 23 CCR§2646 ❑ b.STATISTICAL PER 23 CCR§2646.1 M24. ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)PER 23 CCR§2645 TESTING PERIOD: n a.36 HOURS ❑ b.60 HOURS M25. ❑ 5.INTEGRITY TESTING PER 23 CCR§2643.1 TEST FREQUENCY: [] a.ANNUALLY 0 b.BIENNIALLY [3 c,OTHER(Specify): M26. M27. 0 &VISUAL MONITORING DONE: El &DAILY [I b.WEEKLY Mww army wp.9) 0 99.OTHER(Specify): M2& V. PIPE MONITORING MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) M30. 1.CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(S)(TRENCH(ES)AND OTHER SECONDARY CONTAINMENT SECONDARY CONTAINMENT IS: 01-DRY [IID LIQUID FILLED ❑ c,UNDER PRESSURE [I d.UNDER VACUUM PANEL MANUFACTURER: U QeC-A& 11,,tJ m2- MODEL#: -rL S 350 M33. LEAKSENSOR MANUFACTURER: i jae.6at RQzJ M34- MODEL#(S): -7,�q3yz -ac)? M35. WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP(Le,TURBINE)SHUTDOWN? A a.YES ❑ b.NO M36 WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC FAR SHUTDOWN9 jq a.YES ❑ b No M37 2.MECHANICAL LINE LEAK DETECTOR (NILM) THAT ROUTINELY PERFORMS 3.0 g.ph. LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED k2A MLLD MANUFACTURER(s): M38 MODEL#(S): ✓ M39.IQ SS EeA ri 3.ELECTRONIC LINE LEAK DETECTOR(FLED)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS ELLD MANUFACTURER M40. MODEL#: M41. PROGRAMMED LINE INTEGRITY TESTS: [1a.MINIMUM MONTBLY0.2g.p.h. [I b.MINIMUM ANNUAL 0.1 gp.h. M42, WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M43. WILLELLD FAILURE/DISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M44- El 4.INTEGRITY TESTING TEST FREQUENCY: n a.ANNUALLY ❑ b.EVERY 3 YEARS 0 c.OTHER(Specify) M45. M46. ❑ 5.VISUAL MONITORING DONE: n a.DAILY 0 b.WEEKLY* [] c.MN MONTHLY&EACH TIME SYSTEM OPERATED- M47 *Req--W-cy approval "Allowed form ofunbuned emagatcy Sawrator ffid pWmg oidy pw MC§M281.5(b)(3) ❑ 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) _E1 99.OTHER(Specify) M48. SJCEHD-d(07/03)-1/4 07/23/03