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SAN JOAQtWOUNTY ENVIRONMENTAL HEALTHWARTMENT <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN- PAGE 1 <br /> TYPE OF ACTION ❑ 1.NEW PLAN CHANGE OF INFORMATION Mol. <br /> PLAN TYPE &MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. Moe. <br /> (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): <br /> I. FACILITY INFORMATION <br /> FACILITY ID#(Agency Use Only) _ _ <br /> FACILITY NAME USA. M03. <br /> FACILITY SITE ADDRESS 3 S U C ke f,U ✓ems LJ m04' CITY LO 1 C,!J`a LQ M05. <br /> II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE <br /> State law requires that testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)be performed in M06 <br /> accordance with the equipment manufacturers'instructions,or annually,whichever is more frequent. Such work must be performed by qualified personnel. <br /> MONITORING EQUIPMENT IS SERVICED '04,ANNUALLY ❑ 99.OTHERfY)S eci � MOT <br /> ( P <br /> III. MONITORING LOCATIONS <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 map,etc.)which shows all required information,include it with this plan. <br /> IV. TANK MONITORING <br /> MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S):(Check all that apply) M10. <br /> 1.CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) <br /> SECONDARY CONTAINMENT IS: X, a.DRY ❑ b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM Mu. <br /> PANEL MANUFACTURER: 6;1 6xrc_CO M12. MODEL#: .5-: M L M13. <br /> LEAK SENSOR MANUFACTURER: 1I 2 e- Qr' MI4. MODEL#(S): yaz M15. <br /> ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S) <br /> PANEL MANUFACTURER: M16. MODEL#: MIT <br /> IN-TANK PROBE MANUFACTURER: MIB. MODEL#(S): M19. <br /> LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY M20. <br /> ❑ d.MONTHLY ❑ e.OTHER(Specify): M21. <br /> PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): M22. M23. <br /> ❑ 3.INVENTORY RECONCILIATION ❑ a.MANUAL PER 23 CCR§2646 ❑ b.STATISTICAL PER 23 CCR§2646.1 M24. <br /> ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)PER 23 CCR§2645 <br /> TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS M25. <br /> ❑ 5.INTEGRITY TESTING PER 23 CCR§2643.1 <br /> TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): M26. M27. <br /> ❑ 6.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(Requires agency approval) <br /> ❑ <br /> 99.OTHER(Specify): M28. <br /> V. PIPE MONITORING <br /> MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) M30' <br /> ❑ 1.CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(S)/TRENCH(ES)AND OTHER SECONDARY CONTAINMENT <br /> SECONDARY CONTAINMENT IIS: �fe.DRY ❑ b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM M"- <br /> PANEL MANUFACTURER: b i �-A rGc3 M32. MODEL#: .0_,pyl C_ M33. <br /> LEAK SENSOR MANUFACTURER: LItee r -ea C.+ M34. MODEL#(S): 205 M35. <br /> WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN? X a.YES ❑ b.NO M36. <br /> WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? g a.YES ❑ b.NO M37. <br /> 2 MECHANICAL LINE LEAK DETECTOR (MLLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF <br /> PRODUCT FLOW WHEN A LEAK IS DETECTED <br /> MLLD MANUFACTURER(s): V M Z- M38. MODEL#(S): 1 p �1 t� <br /> L-b Zoo M39 <br /> ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS <br /> ELLD MANUFACTURER: M40. MODEL#: M41. <br /> PROGRAMMED LINE INTEGRITY TESTS: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. M42• <br /> WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M43. <br /> WILL ELLD FAILURE/DISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M44. <br /> ❑ 4.INTEGRITY TESTING <br /> TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) M45. M46. <br /> ❑ 5.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY* ❑ c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED** M47. <br /> *Requires agency approval **Allowed for monitoring of unburied emergency generator fuel piping only per HSC§25281.5(b)(3) <br /> ❑ 6.PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXEMPTION FROM MONITORING PER 23 CCR§2636(a)(3) <br /> ❑ 7.NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) <br /> ❑ 99.OTHER(Specify) M48. <br /> SJCEHD-d(07/03)-1/4 07/23/03 <br />