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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK JUN 2011 MONITORING PLAN- Pae 1 of 2) TYPE OF ACTION ❑1.NEW PLAN 2.CHANGE OF INFORMATION 490-1 PLAN TYPE 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. PERMIT/SEFMCW (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEMS) 1. FACILITY INFORMATION, FACILITY ID#(Agency Use Only) ® - 47 BUSINESS NAME(Same as FACILITY NAME) 04.6u L BUSINESS SITE ADDRESS 'Lt(0i a 0-L S' 1o3. CI 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 2641 -.._._-___J-__ ._--_z___ - _-_ __--_--_-_ -- --__-_-- --_ _-_-_ _ _-�--- __ __ __._____- MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY ❑ 99.OTHER(Specify): 490-36 III.MONITO G LOCATIONS i.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. bj.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 63 24 4904 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 I : ❑ a_DRY b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM avo-6 ----------- ------------------------------------- --- -- - --_-- ------------------------------------_ PANEL MANUFACTURER: ago-z i MODEL#: v a9as -- -- --------- - --- - -' ----- - - �?- L LEAK SENSOR MANUFACTURER: _ 490-9. i MODEL#(S): ` -0--303 490-10 ❑ 2.AUTOMATIC TANK GAUGING(ATG) STEM USED TO O ITOR SINGLE WALL TANK(S).(23 CCR§2643) 49011 -------------------PANEL MANUFACTURER: 490-12. 490-13 MODEL#: -----------------------------------------------------------------------------------------.a90-14 ------------------------------------------------------- IN-TANK PROBE MANUFACTURER: MODEL#(S)_ 490-15-- _ ----------------------------------------------------------------------------------------------------------------------------- -------------------------------------- LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490-16 ❑ d.MONTHLY ❑ e.OTHERS ci 4v°-17 ---------------------- ( pe fY); ----------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------- PROGRAMMED TESTS: ❑ a.0.1 h. ❑ b.0.2 h. ❑ c.OTHER S eci 490-18 g.p.h. g.p.h. ( p �')� 490-I9 ❑ 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 El b.60 HOURS 490-22 ❑ 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 TEST FREQUENCY: ❑ a.ANNUALLY El b,BIENNIALLY E] c.OTHER(Specify): 490-25 490-26 ❑ 99.OTHER (Specify): 490-27 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check 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: .DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM 0-v°-zv ----------------------------------------------- -- -- - - -- -......... - ---- -490------_ --- - ------------------- - ® 490-30 •- 490-31 PANEL MANUFACTURER: �_ l) -� MODEL#: -U W -------------------------------------- ----- LEAK SENSOR MANUFACTURER: 490-32490 33 MODEL#(S): rnY ------------------------------------------------ - PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. [Ia.YES Wb.NO 490-34 FAILUREMISCONNECTION 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 2636 490-36 MLLD MANUFACTURER(S): 490-37 MODEL#(S): 490-38 ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) ago-39 ELLD MANUFACTURER(S) 49040 I MODEL#(S): avo41 - - - ----- - ---------------------------------------------------------------------------------'---------------- - -- ----------------------------------- PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. 49042 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49043 ELLD FAILUREMISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49044 ❑ 4.PIPE INTEGRITY TESTING 49045 TEST FREQUENCY ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 490-4649047 ❑ 5.VISUAL PIPE MONITORING. 490-48 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 490.49 "Allowed for monitoring of unburied emergency enerator fuel piping only per HSC 25281.5 6 3 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(a)(3)1. 490-50 ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490-s1 490.52 ❑ 99.OTHER(Specify) 490-53 UPCF UST-D(12/2007)1/4