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A UNIFIED PROGRAM CONSOLIDATED FORMW UNDERGROUND STORAGE TANK MONITORING PLAN-(Pagel of 2) TYPE OF ACTION ❑I NEW PLAN 2.CHANGE OF INFORMATION 4901 PLAN TYPE Ef 1.MONITORING IS IDENTICAL FOR ALL USTS AT THIS FACILITY. 490.2 (Check one item only) 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S.)- I. FACII371rY INFORMATION FACILITY ID#(Agency Use Only) - - ' BUSINESS NAME(Same as FACILITY NAME) C LD N® G CC- 3. BUSINESS SITE ADDRESS R ed E. Vi(!-TO R3 103_ Com' ,D 3)-L 104. H.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,and that such work must be performed by qualified personnel. 23 CCR§2632,2634,2638,2641 49048 MONITORING EQUIPMENT IS SERVICED I.ANNUALLY ❑ 99.OTHER(Specify): 4903b III.MONITO G-LAXATIONS ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 2634)49o-4 IV.TANK MONITORING IS PERFORNED USING THE FOLLOWING METHOD(S): 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIA[.)SPACE(S)OR SECONDARY CONTAINMENT 490-5 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CR§2632,2634 . ) SECONDARY CONTAINMENT IS: �y a.DRY b.LIQUID FELLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 49D-6 PANEL MANUFACTURER: r A P-00 490-7' MODEL#: T4 S 3So 49" LEAK SENSOR MANUFACTURER (ZP c-T 490-9_ MODEL#(S): O 30 1 490.10 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE A&L TANKIS).(23 CCR§2643) 490-11 PANEL MANUFACTURER: 490-12. MODEL#: 490-13 IN-TANK PROBE MANUFACTURER: 490-14. MODEL#(S): 490-15 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 49016 ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17 490.18 PROGRAMMED TESTS: ❑ a.0.t g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): 490.19 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490.20 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 4 22 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 4�i4 TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 490-25 490.26 ❑99.OTHER (Specify): 490.27 V.PIPE MONMIMG IS PERFORMD USING ME FOLLOWING METHOD(S)(Check all that apply) CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-29 ALARMS. (23 CCR§2636) 490-29 / SECONDARY CONTAINMENT IS:[Ja.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM PANEL MANUFACTURER V 0 b j 490.30 MODEL#: jl�S, 3 5 D 490-31 LEAK SENSOR MANUFACTURER _V E O T 490.32 MODEL#(S): 20'a 490-33 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. Ria.YES ❑b.NO 490-34 FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. MA YES ❑b.NO 490.35 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 23 CCR 26 490-36 MLLDMANUFACTURER(S): F C TP O v T 17 MODEL L,D-2000 490-38 ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g4Lh.LEAK TESTS (23 CCR§2636) 490-39 ELLD MANUFACTURER(S) ONO 1MODEL#(S): 490-01 PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.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 FAMUREIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49044 4.PIPE INTEGRITY TESTING 49o45 TEST FRE UENCY Ej a.ANNUALLY Q b.EVERY 3 YEARS Q c.OTHER S i 490-46490.47 5.VISUAL PIPE MONITORING. 490-49 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 490649 • for ofudRmed fuel i' HSC 28L3 3 ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA[23 CCR§ aX3)]. 490-50 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490.51 49052 ❑ 1 R(Specify) 490.53 UPCIF LIST-D(1 Z7M 114