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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN-(Page 1 of 2) 1A An CAI n TYPE OF ACTION ❑ I.NEW PLAN ® 2.CHANGE OF INFORMATION 490-1 PLAN TYPE ® 1.MONITORING IS IDENTICAL.FOR ALL USTs AT THIS FACILITY. ENTAL HEALN (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION _ FACILITY ID#(Agency Use Only) ' BUSINESS NAME(Same as FACILITY NAME)ARCO 05450 3 BUSINESS SITE ADDRESS 1617 W FREMONT 103CITY 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;and that such work must be performed by qualified personnel. (23 CCR§2632,2634,2638,264 - ---- ----------- -- -- -- ---- --------------- ---- -- -- - ---3a MONITORING EQUIPMENT IS SERVICED ® I.ANNUALLY El 99.OTHER(Specify): 490-3a Y)� -490-46 III.MONITORING LOCATIONS ®1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. ❑2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 2634)490-4 IV,TANK MONITORING'IS PERFORMED USING THE FOLLOWING METHOD(S): ® 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490-5 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: ® a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490-6 ______---------_ _ _ __ _-_-____________-____________-____-_-490-7._'______-__-________________-_-____-__-.___- 490-8 PANEL MANUFACTURER VEEDEI' ""0T MODEL#: TLS-3508 ----------- -------- --------------------------- --- ------- - ----- ------ 490-9. 1 490-10 LEAK SENSOR MANUFACTURER: V MODEL#(S): 794390-409 490-11 ❑ 2.AUTOMATIC TANK GAUGING(ATG)S' LL TANK(S).(23 CCR§2643) 490-13 PANEL MANUFACTURER: * . -11 MODEL#: ------------------------------------------------ 490-14 -------------------------------------- - IN-TANK PROBE MANUFACTURER: MODEL#(S): 490-15 ----------------------------------------------------------- ---------------------------------------------------------------------------------- LEAK TEST FREQUENCY: ❑ a I D.DAILY/NIGHTLY ❑ c.WEEKLY ago-16 ❑ d. ®4 e.OTHERS cif 490-17 Y - (Specify): - - ------ ------------------ ----------------- -------- --- - - PROGRAMMED TESTS: ❑ a c.OTHER49-1 s (Specify): 490-19 ❑ 3.MONTHLY STATISTICAL INVENTO 490-20 ❑ 90-21 4.WEEKLY MANUAL TANK GAUGINI �i PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS ago-22 F15.TANK INTEGRITY TESTING(23 CCR§2643.1): (UjI SU 1 490-23 TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY c.OTHEK ecif 490-24 Q ❑ t N Y)� 490-25 49-26 ❑99.OTHER (Specify): 4900-27 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHODS)(Cheek all that apply) ® 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-28 VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS:®a.DRY [1b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER-VACUUM 49°-z9 ---------------------------- ---------- -------------------- ---------------- 490-30 ------ '- PANEL MANUFACTURER:VEEDER ROOT _ MODEL#: TLS-350R 490-31 490-32 490-33 LEAK SENSOR MANUFACTURER: VEEDER ROOT 1 MODEL#(S):-794380-323 -- --- ----------------------------------------------------------------------------------- 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 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 X2636) -- -_ 490-36 MILLI)MANUFACTURER(S): ago-37 MODEL#(S): 490-38 ® 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490-39 ---------------------------------- ---------- --- ------ ---- -- ELLD MANUFACTURER(S): VEEDER ROOT ago-ao. MODEL#(S): PLLD 490-411 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 49043 ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ®a.YES ❑b.NO 490-44 ❑ 4.PIPE INTEGRITY TESTING 49045 TEST FREQUENCY ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 490-46490-47 ❑ 5.VISUAL PIPE MONITORING. 490-48 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 49049 *Allowed for monitonn of unburied emergmcy generatorfuel pipingonly per HSC§25281.5(b)(3) ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(a)(3)]. 490-50 ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490-52 490-s 1 ❑ 99.OTHER(Specify) 490-53 Arco 05450,Belshire Environmental Services