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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN -(Page 1 of 2) TYPE OF ACTION ❑ 1.NEW PLAN [1 2.CHANGE OF INFORMATION f 12011 490-1. PLAN TYPE ® 1.MONITORINGIS IDENTICAL FOR ALL USTs AT THIS FACILITY. SAN 490-2. (Check one item only) E] 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): VIRON� NTAI I. FACILITY INFORMATION HEALTH DEPARTMENT FACILITY ID#(Agency Use Only) 1. BUSINESS NAME(Same as Facility Name or DBA) UPS Stockton 3 BUSINESS SITE ADDRESS 1532 North Broadway 103' CITY Stockton 104 II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must be performed at the frequency specified by the equipment manufacturers instructions,or annually,whichever is more frequent.Such work must be erfonned b ualified personnel.[23 CCR i 2632,2634,2638,2641) ........... .....q.. - ......... ....-..-.... .....I?........ .. Y q.......... ..P .......... ..... . .. ....... . ...... ......... MONITORING EQUIPMENT IS SERVICED 490-3a. Q ® 1.ANNUALLY ❑ 99.OTHER(Specify): 490-36. III. MONITORING LOCATIONS ❑ 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN ® 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED [23 CCR 12632,2634] 490-4. IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) hah aek l) ® 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) 490-5. WITH AUDIBLE AND VISUAL ALARMS.[23 CCR 12632.26341 SECONDARY CONTAINMENT IS: ❑ a.DRY ® b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 490-6. PANEL MANUFACTURER: Veeder Root TLS-350 490-7. MODEL#: 0847090-022 490-8. 9. LEAK SENSOR MANUFACTURER: Veeder Root 490- MODEL#(S): 302 490-10. ............................... ❑ 2.AUTOMATIC TANK GAUGING ATG SYSTEM USED TO MONITOR SINGLE WALL TAN *.[23 CCRt2643] 490.11. PANEL MANUFACTURER: 490-12. MODEL#: 490-13. IN-TANK PROBE MANUFACTURER: 491-14. MODEL#(S): 490-15. LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490-16. ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17. PROGRAMMED TESTS: ❑ a.0.1 h. ❑ b.0.2 h. ❑ c.OTHER(Specify): a9°-18. g.p.h. _............._g..p............"................................................................._........�....p..........._Y�.:..... .........avo ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION[23 CCRI2646.11 490-20. ....................................................................................................................................... ....................................................................................................................-....................................-.......-....................................................................................................-...._......................................................................................................................... . ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)[_,3 CCR I2645] TESTING PERIOD: ❑ a.36 HOURS E] 4 b.60 HOURS 4990 490-.I. ..............................................................................-...........................................................................................................................................`.............................................................-..............................................................-................................................................................ . ❑ 5.TANK INTEGRITY TESTING PER[23 CCR 12643 .1] 490-23. TEST FREQUENCY: ❑ ANNUALLY 490-24. .................................._..................'........_Q........................_..........................................._..._....._a......._........._............................................_❑ b.BIENNIALLY ❑ c.OTHER(Specify): ago-_s ❑ 99.OTHER(Specify): 490-26. 490-27. V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) that kall ® L CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 490-28. [x2636, SECONDARY CONTAINMENT IS: ® a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 490-29. PANEL MANUFACTURER: Veeder Root TLS-350 490.30. MODEL#: 0847090-022 490-31. LEAK SENSOR MANUFACTURER: Veeder Root 490-32. MODEL#(S): 208 490.33. PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ® a.YES ❑ b.NO 490-34. FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑ b.NO 490-35. _.................................................................................................................................................................................................................................. ® 2.MECHANICAL L[NE LEAK DETECTOR(MELD)THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF 490-36. PRODUCT FLOW WHEN A LEAK IS DETECTED.[23 CCRI2636I MLLD MANUFACTURER(S):Va orleS8 490.37. MODEL#(S): 99LD2000 490-38. ..........................................................................................-....................................... ...........................-............................... ......... ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.123 CCRa126361 490-39. ELLD MANUFACTURER(S): 490-40, MODEL#(S): 490-41. PROGRAMMED IN LINE LEAK TEST: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. 490-42. ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 490-43, ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 490-44. ......................................................................................................................................................................................-..........................................-...............................................................................-............ . ..... . ........................................................................................................................................................................................... 4.PIPE INTEGRITY TESTING. 490-45. TEST FREQUENCY: ❑ a.ANNUALLY 490-46. Q ® b.EVERY 3 YEARS ❑ c.OTHER(Specify) 49047. .................................................................................... ❑ 5.VISUAL PIPE MONITORING. 490-4a. FREQUENCY: ❑ a.DAILY ❑ b.WEEKLY ❑ C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 49049. *Allowed for monitoring of unburied emergency generator fuel piping only per HSC 125281.5(b)(3) ......................................................................................................................................................................................................................................................................................................................................................................................................................_......................................... ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA.[23 CCR I2636(a)(3)] 490-50. -..............................................._............................-..............................................................................................................................................................................._..............................................................._................................._..................................................................................................................._..............._.............................. 490-51...................... ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM. ......................_.....................................-............................-.............._................................... __...._....._.........._.............._........................................................................................._..............................................................-...................._..............__..............._.................................................................. ..................... 490-5_. ❑ 99.OTHER(Specify) ago-53.