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UNIMD PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONJITORING FLAN- 1 of2j TYPE OF ACTION ❑1.NEW PLAN 2.CHANGE OF INFORMATION 490.1 PLAN TYPE 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490-2 (Ch one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYS FACILITY #(Agency Use(may) BUSINESS N E(Same as FACILITY NAME)Valley PaGft Petroleum Cardtock-Charter Way 3 BUSINESS SITE A KESS 15111 W.C er y 103 CITY St on ,a. Testing,preventive mainterloce,and calibration of monitoring equipment(e.g.,sensors,probes,line leak dateetorsAft.)must be performed at the frequency specified by the equipment facturars'instructions,or annually,whichever is more firequent and that suchwo must be performed by qualified personnel. 23 CCR'2632.2634 2638 2 MONITORING EQUIPMENT I ERVICED M 1.ANNUALLY ❑ 99. HER( � �)� 490.3S(Specify): 490-3kIb 6 MiREW SITE PLOT PLANIMAP 804"WITHTHIS PLAN. M2.SIT9PLOTPI, 00MAPPREVIOUSLYSUBMITTED. (23 CCR§2632, 2634)490-4 I.CONTINUOUS ELECTRONIC T ��.j OF ANN )SPACE(S)OR SECONDARY CONTAINMENT 490.5 VAULT(S)WITH AUDIBLE AND VTSU (23 CCR§2632,2634)SECONDARY CONT IS: b.LIQUID FILLED c.PRESSURIZED490.6 ❑d.UNDER VACUUM PANEL MANUFACTURER: {� 490.7' _MODEL#' gII �- ----- 4"-E LEAK SENSOR MANUFACTURER.- r 491-9' MODEL 3):420 490-10 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM U TO MONTTSIN, ' W TANKtS1 (23 CCR§2W) 490-11 PANEL MANUFACTURER: 490.12. MODEL#: 490.13 IN-TANK PROBE ACTURER: 490.14. MODEL#(S): 490.1 LEAK TEST FREQUENCY`. ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490616 ----------------------- -® d_MONTHLY-- -- ------®e.OTHER(S eci +): ---- 490-17 PROGRAMMED TESTS: 490.18 ❑ a.0.I g.p.h. b.0.2 g. h. ❑ c.OTHER(Specify): 490.19 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCI N(23 CN§2646.1): 490.20 ❑ 4.WEEKLY MANUAL TANK GAUGING'(MTG)(23 Co§2645). TING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 490-21 490-22 S.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BI TALLY ❑ c.O Specify): 490-24 ' 490-25 ❑99.OTHER (Specify): 493-26 to - 49147 2�v 1.CONTINUOUS MONITORING OFG'S AND SECONVAR CONTAINMENT AUDIBLE AND 491-28 VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENTIS:❑0. D ❑b.LIQUID FILLED ❑c.PRESSURIZED d.UNDER VACUUM _ 490-29 PANEL MANUFACTURER: 490-30 DEL#: -� 490•31 LEAK SENSOR MANUFACTURER: 490.32 MODEL s): 208 490-33 PIPING LEAK ALARM TRIGGERS OMATIG PUMP(i.e.,TURBINE)SHUTDOWN. a.YES ❑b.NO 490-34 FAILURE/DISCONNECTION OF MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP S a.YES [3 b.NO 493.35 2.MEJCHANICAL LINE LEAK TECTOR(MLLD)THAT ROUTINELY PERFORMS3.0 g LEAK TS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A AK I&DETECTED 23 CCR 490-36 MLLD MANUFA S): FE Petro 490-37 MODEL#(S). P-h1LD 490-38 ❑ 3.ELECTRONIC LINE LEA DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g p h.LEAK TESTS_ CCR§2636) 490-39_ ELLD MANUFACTU S) -440' MODEL#(S): 491-41 PROGRAMMED IN L LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL g.p.h. ------- 49042 ELLD DETECTION F A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES b.NO 490 43 ELLD FAILUR SCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES b.NO 4904A 4.PIPE INTEGR TESTING 490-45 TEST FRE CY 0 a.ANNUALLY b.EVERY 3 YEARS Q c.OTHERS eci 4.4. 5.VISUAL PIPE MONITORING. 490-48 FREQUEkjCY ❑ a.DAILY ❑ b.WEEKLY ❑c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED" 49049 Allowed for of wburied r.ftw mma only eu HSC 25281.5 3 - ❑ 6.SUCTION PIPING MEETS=EXEMPTION CRITERIA 123 CCR§ a)(3)j. 490s0 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYS 490-51 ❑ 99.OTHER(Specify) 490-52490.53 UPCF UST-D(12/2007)1/4