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. t <br /> t'NIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN-(Page 1 of 2) <br /> TYPE OF ACTION ❑ 1.NEW PLAN ® 2.CHANGE OF INFORMATION 440-1 <br /> PLAN TYPE ® I.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490-2 <br /> (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM()' <br /> FACILITY INFORMATION.. <br /> FACILITY ID#(Agency Use Only) - t <br /> BUSINESS NAME(Same as FACILITY NAME) Grant Line Shell # 136187 3. <br /> BUSINESS SITE ADDRESS 2375 W.Grant Line Road I°3. CITY Tracy 104. <br /> II :EQUll'MENT TESTING AND:PREVENTNE MAINTENANCE <br /> Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must be performed at the frequency <br /> specified by the equipment manufacturers'instructions,or annually,whichever is more frequent,and that such work must be performed by qualified personnel. <br /> 23 CCR 2632,2634,2638,2641 <br /> MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY [199.OTHER(Specify): 490-3b <br /> P �')- 490-36 <br /> aiTOR.!: <br /> III.is <br /> t,dl;P�46 ,,,,.,:z1YIO� <br /> ING L,OCtIT,Q�1tS.zs,�f�u„e�l�I�Ih�,:4..,u � ,:.,s ,-,•.,,�,,,,�,,,.,,,t.,,xt,l� x., .,,,:.;i,,.R i. <br /> ®1.NEW SITE PLOT PLAN/NIAP SUBMITTED WITH THIS PLAN. ❑2.SITE PLOT PLAN/NIAP PREVIOUSLY SUBMITTED. (23 CCR§2632, <br /> 2634)490-4 <br /> !,!fi' IV'�I'ANI{MQtITORIIV IS PERFORMED:USING;;THEOLLOWING:METHOD(S) <br /> N 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490-5 <br /> VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) <br /> SECONDARY CONTAINMENT IS: ❑ a.DRY N b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490-6 <br /> -- -------------------- --- -- ---_- -------- -- --- - --- -- - -- - ------- <br /> PANEL MANUFACTURER: Veeder Root 490'7 MODEL#: TLS-350 440 8 <br /> ----------------- ---- - __--_ - - -- - -- --_ -------------------------------------------- - - _ - <br /> LEAK SENSOR MANUFACTURER: Veeder Root 490-9. MODEL#(S): 794380-301 490-10 <br /> ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 490-11 <br /> PANEL MANUFACTURER: 490-12- MODEL#: 490-13 <br /> _------------------------ ----- ---- --- -- - ------ ------- - <br /> IN-TANK PROBE MANUFACTURER: 490-14. MODEL#(S): ago-ls <br /> ---------------___ --_-___�- __-_ -_-_---------_---. ____� -_----------------- __---_-------------- <br /> LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILYINIGHTLY ❑ c.WEEKLY x90.16 <br /> ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17 <br /> PROGRAMMED TESTS: ❑ a.0.1 h. ❑ b.0.2 h. ❑ c.OTHER(Specify): 490-1s <br /> g•P• g•P• fY)� a90-19 <br /> ❑ 3.NIONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490-20 <br /> ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 490-22 <br /> 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 <br /> 490-24 <br /> TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 490-25 <br /> N 99.OTHER (Specify): Simplicity 490 26 <br /> 490-27 <br /> V,PIPE VIONITQRING,IS PERFORMED USING TfIE kOLLOV}' NG�VIETHOD(S)(Ch;eck all that,iapply); i ,„,;; <br /> N 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-28 <br /> VISUAL ALARMS. (23 CCR§2636) <br /> SECONDARY CONTAINMENT IS:Na.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED [:Id.-UNDER-VACUUM 490-29 <br /> PANEL MANUFACTURER: Veeder Root 490-30- _ MODEL#: TLS-350 490-11 <br /> v LEAK SENSOR MANUFACTURER: Veeder Root--^ -� -090-32 MODEL#(S): 79430 <br /> .8 -352;208 - 490-33 <br /> - PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. N a.YES ❑b.NO-- _ 490-34 <br /> FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. N a.YES ❑b.NO 490-35 <br /> 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF <br /> PRODUCT FLOW WHEN A LEAK IS DETECTED 23 CCR2636 490-36 <br /> MLLD MANUFACTURER(S): 490-37 MODEL#(S): 490-38 <br /> N 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490.39 <br /> ----------------------- -- -----i ----- ------ - -- <br /> ELLD MANUFACTURER(S) Veeder Root ! MODEL#(S): PLLD <br /> 49040. 49041 <br /> -__-______-_______---_-______________gP_______ ________-----_-_--________________________ <br /> PROGRAMMED IN LINE LEAK TEST: ❑ I.MINIMUM MONTHLY 0.2 h- El2.MINIMUM ANNUAL 0.1 g.p.h. 490-42 <br /> ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. (]a.YES ❑b.NO 49043 <br /> ELLD FAILUREIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. 0 a.YES ❑b.NO 49044 <br /> ❑ 4.PIPE INTEGRITY TESTING 49045 <br /> TEST FREQUENCY ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 49046 49047 <br /> ❑ 5.VISUAL PIPE MONITORING. 49048 <br /> FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 490.49 <br /> Allowed for monitoring of unburied emergency enerator fuel pipirig only per HSC 25281.5 3 <br /> ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(a)(3)1. 490-50 <br /> 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM <br /> 490.51 <br /> ❑ 99.OTHER(Specify) 490490..52 <br /> 53 <br /> USt•Itesponse Plan(3/2008)3/3 <br />