Laserfiche WebLink
r>� <br />TYPE OF ACTION <br />F(Check <br />AN TYPE <br />one item only) <br />SAN. JOAQUINT-5UNTY ENVIRONMENTAL HEALTH R <br />UNDERGROUND. STORAGE TANK <br />MONITORING PLAN - PAGE 1 <br />rj 1 _ NEW PLAN CHANGE OF INFORMATION <br />MONITORING IS. IDENTICAL FOR ALL. USTS AT THIS. FACILITY. <br />THIS PLAN. COVERS, ONLY THE FOLLOWING UST SYSTEM(S)--_ <br />ID A(Agency Use Only) <br />FACILITY NAME <br />FACILITY. SITE ADDRESS <br />CITY <br />M01. <br />M03. <br />State law requires that testing, preventive maintenance, and calibration of monitoring equipment (e.g ,sensors, probes, line leak detectors, etc.) beperformed in Mob <br />accordance with the equipment manufacturers' instructions, or annually, whichever. is more. frequent. Such work must be performed by qualified personnel. MOS. <br />MONITORING. EQUIPMENT IS SERVICED.1.. ANNUALLY ❑ . 99- OTHER (Specify) <br />s x <br />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, <br />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 <br />form_ Hazardous Materials Business Plan ma , etc.) which shows all required information, include it with this Qn. <br />MONITORING 1. IS PERFORMED USING THE FOLLOWING METHOD(S):. (Check all that apply) <br />I. CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR (INTERSTITIAL) SPACE(S) OR SECONDARY CONTAINMENT VAULT(S) <br />d. UNDER VACUUM <br />Mil. <br />SECONDARY CONTAINMENT. IS: a.. DRY Q. b.. LIQUID FILLED ❑. M1 UNDER PRESSURE ❑. <br />Q �J.L � <br />SECONDPANEL <br />M13 <br />'�) �/ �� MODEL#: /CM� O OVK+`_Q_- <br />MANUFACTURER: �,� k <br />rino�Qa,. j�K� M14. MODEL#(S):f122L <br />LEAK SENSOR MANUFACTURER:_ <br />❑ 2- AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SINGLE WALL TANKb(S) <br />MIT <br />MODEL #: <br />PANEL MANUFACTURER: MIB MODEL #(S): <br />M19. <br />IN -TANK PROBE MANUFACTURER: <br />b_ DAILY/NIGHTLY ❑. c. WEEKLY <br />LEAK TEST FREQUENCY: ❑. a_ CONTINUOUS ❑ MSI <br />0' <br />❑.. d. MONTHLY 0. . e.. OTHER (Specify): <br />2 <br />M24. <br />c.. OTHER (Specify): <br />PROGRAMMED TESTS: ❑ a. 0.1. g.p.h. ❑. b.. 0.2 g.p.h. 11M24. <br />❑ b.. STATISTICAL PER 23. CCR §2646.1 <br />❑ 3. INVENTORY RECONCILIATION ❑. a.. MANUAL PER 23. CCR §2646 <br />❑ 4. WEEKLY MANUAL TANK GAUGING (MTG) PER 23. CCR §2645 <br />M25 <br />TESTING PERIOD: 11a. 36. HOURS ❑. b_ 60. HOURS <br />.1. M26.. <br />TEST FREQUENCY: a ANNUALLY [j, b_ BIENNIALLY 11c. OTHER (Specify): <br />M27. <br />in 6.VISUAL MONITORING DONE: a DAILY ❑.. b. WEEKLY 01-v�ir­ -9-cr_ww"d) <br />M28. <br />❑ 99 OTHER (Specify) <br />MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply). <br />I . CONTINUOUS. ELECTRONIC MONITORING OF. PIPING SUrIp(Sx TRENCHES) AND. OTHER SECONDARY. CONTAINMENT <br />c. UNDER PRESSURE ❑. d. UNDER VACUUM <br />M31. <br />SECONDARY CONTAINMENT. IS: a_ DRY Q b_ LIQU FILLED ❑ M3M33. <br />2� MODEL #: P �' � �X-� (�O <br />PANEL MANUFACTURER: M34 M3s. <br />MODEL #(S): -An T� LEAK SENSOR MANUFACTURER: ❑ , a YES ❑. b_ NO M36. <br />WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP. (i.e., TURBINE) SHUTDOWN? M37. <br />YSTEM TRIGGER AUTOMATIC. PUMP. SHUTDOWN? ❑. a YES El b. NO <br />WILL FAILUREIDISCONNECTION.OF THE MONITORING S <br />Y PERFORMS. 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS. O of <br />2. MECHANICAL LINE LEAK DETECTOR (MILD) THAT ROUTINELY . ��^ ^ 2 OJ -000C <br />PRODUCT FLOW WHEN A LEAK IS. DETECTED V J� ! W8. MODEL #(S): ^T� <br />MLLD MANUFACTURER(s): p� I OZD o' <br />113. ELECTRONIC LINE LEAK DETECTOR (EL )THA . ROUTINEL PERFORMS. 3.0. g.p.h_ LEAK TESTS M41. <br />M40• MODEL #: o O� <br />ELLD MANUFACTURER: M42. <br />PROGRAMMED LINE INTEGRITY TESTS: ❑ <br />a. MIAIIMUM MONTHLY.0.2 g.p.h. ❑. b.MINIMUM ANNUALa . 0.1. g.p.h. M43. <br />YES [j b., NO <br />WILL ELLD DETECTION OF A PIPING. LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑a. YES [Ib. NO M44. <br />WILL ELLD FAILUREMISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ <br />M45. M46. <br />a ANNUALLY ❑. b. EVERY 3 YEARS. ❑ . c.. OTHER (Specify) <br />TEST FREQUENCY: b WEEKLY* ❑.. c. MIN. MONTHLY & EACH TIME SYSTEM OPERATED" Mai. <br />❑ 5. VISUAL MONITORING DONE: ❑ a DAILY �� r approval Allowed f" monitoring of unburied emerB�cy genemlor feet piping only. per NSC 415281.5(6x3) <br />.. <br />❑ 6. PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS. FOR EXEMPTION FROM MONITORING PER 23 CCR §2636(ax3) <br />❑ 7- NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) Mas. <br />❑ 99. OTHER (Specify) 07/23/03 <br />SJCEHD-d (07/03) - 1/4 <br />