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r_7 <br />a <br />IFIED 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 <br />490.1 <br />PLAN TYPE ® I. MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. <br />490.2 <br />(Check one item only) ❑ 2. THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(U <br />I. FACILITY INFORMATION <br />FACILITY ID # (Agency Use Only) - <br />1 <br />BUSINESS NAME (Same as FACILITY NAME) Grant Line Shell <br />3' <br />BUSINESS SITE ADDRESS 2375 W. Grant Line Road 103 <br />CITY Tracy <br />104. <br />II. EQUIPMENT TESTING AND PREVENTIVE 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 CCRj2632y2634, 2638,2641)_ _ _- _ _ ---- _.-... -- --- -- - _ __--- - - --- - - - -- <br />_•-- <br />MONITORING EQUIPMENT IS SERVICED ® 1. ANNUALLY [199.OTHER (P f1')� S eci <br />490-34 <br />a9oab <br />1(II.,MONITORING LOCATIONS <br />® 1. NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. ❑ 2. SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR §2632, <br />2634)490-4 <br />IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): <br />1. CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR (INTERSTITIAL) SPACE(S) OR SECONDARY CONTAINMENT <br />490-5 <br />VAULT(S) WITH AUDIBLE AND VISUAL ALARMS. (23 CCR §2632,2634) <br />SECONDARY CONTAINMENT IS: ❑ a. DRY ® b. LIQUID FILLED ❑ c. PRESSURIZED ❑ d. UNDER VACUUM <br />490.6 <br />- --- -J ------------ - - - -- - - - - ------------------------------------------- <br />PANEL MANUFACTURER: Veeder Root- 490.7 MODEL #_ TLS -350 <br />- - --------------- <br />- - <br />490.8 <br />- _ -- - - -- ...__ - <br />LEAK SENSOR MANUFACTURER; Veeder Root 490-9. MODEL #(S): 794380-301 <br />490-10 <br />2. AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SINGLE WALL TANK(S). (23 CCR §2643) <br />490.11 <br />PANEL, MANUFACTURER: 490.12. MODEL #: <br />490-13 <br />.... <br />--------- ---- -------------- -----------------.--.......... ------------------- - --------- ----- ------------- ------- - -- - --- - - <br />IN -TANK PROBE MANUFACTURER: 490'14 MODEL #(S)t <br />_ <br />490-15 <br />---------- -- -- ----------- - ----- .... .. .................. - --- - - - - - - <br />LEAK TEST FREQUENCY: ❑ a. CONTINUOUS ❑ b. DAILY/NIGHTLY ❑ c. WEEKLY <br />_- _ <br />491.16 <br />❑ d. MONTHLY El c. OTHER (Specify): ------------ <br />490.17 <br />---- <br />------............... - ------- ------_--•----- --- - .............. - - -- - -•--------•-•-------------------- ------- <br />PROORAMMED TESTS: ❑ a, 0.1 h• ❑ b. 0.2 h. ❑ c. OTHERS eci <br />g.p.h. g�P• (Specify): <br />490 18 <br />490.19 <br />❑ 3. MONTHLY STATISTICAL INVENTORY RECONCILIATION (23 CCR §2646.1): <br />490.20 <br />❑ 4. WEEKLY MANUAL TANK GAUGING (MTG) (23 CCR §2645). TESTING PERIOD: ❑ a. 36 HOURS ED b. 60 HOURS <br />4490.22 <br />5, TANK INTEGRITY TESTING (23 CCR §2643.1): <br />490-23 <br />TEST FREQUENCY: E]& ANNUALLY Elb. BIENNIALLY ❑ c. OTHER (Specify): <br />490.24 <br />® 99. OTHER (Specify); Sim licit <br />490.26 <br />ago -z7 <br />V. PIPE 1VIONITORINGIS PERFORMED USING THE FOLLOWING METHOD(S) (Check all; that apply) <br />1. CONTINUOUS MONITORING OF PIPE/ PIPING SUMP(S) AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND <br />490-28 <br />VISUAL ALARMS. (23 CCR §2636) <br />SECONDARY CONTAINMENT IS; ®a. DRY ❑b• LIQUID FILLED ❑c. PRESSURIZED ❑d. UNDER VACUUM <br />490.29 <br />�___._------------------- ------- MODEL #: �r--� <br />PANEL MANUFACTURER:-$e'&'RL1Tr?im" �� 490.30 -- _ -5 �- _ r - • 490-31 <br />------------------- -- - -- -- - - <br />- --_-.------------------------------0-e•-------------------------------- - -------------- <br />490^32 <br />LEAK SENSOR MANUFACTURER_ Veeder Root MODEL #(S):--- 794380-208, -35Z - 490-33 <br />_ _ _ _ <br />PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP (i.e., TURBINE) SHUTDOWN. ® a. YES ❑ b. NO <br />490.34 <br />FAILUREIDISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a. YES ❑ b. NO <br />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 CCR l2636L-_---_____________________ <br />490.36 <br />MLLD MANUFACTURER(S): 490-37 MODEL #(S): <br />490.38 <br />® 3. ELECTRONIC LINE LEAK DETECTOR (ELLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS (23 CCR §2636) <br />490-39 <br />- <br />-- __- - - ........._..----.._... _ - -- - - - - - _ _ - _ .... _ _ _ - -- - - <br />490.40. <br />ELLD MANUFACTURER(S)- Veeder Root -. MODEL #(S_ PLLD <br />490.41 <br />v_ ._ _ _ -. - <br />PROGRAMMED IN LINE LEAK TEST: ❑ 1. MINIMUM MONTHLY 0.2 g.p.h. ❑ 2. MINIMUM ANNUAL 0.1 g.p.h. <br />49x42 <br />ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a. YES ❑ b. NO <br />490.43 <br />ELLD FAILUREIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a. YES ❑ b. NO <br />490.44 <br />4. PIPE INTEGRITY TESTING 490.45 <br />TEST FREQUENCY ❑ a. ANNUALLY ❑ b. EVERY 3 YEARS ❑ c. OTHER(Specify) 490.46 49047 <br />5• VISUAL PIPE MONITORING. <br />490AS <br />FREQUENCY ❑ a. DAILY ❑ b. WEEKLY ❑ C. MIN. MONTHLY & EACH TIME SYSTEM OPERATED- <br />49049 <br />' Allowed for monitoring of unburied emergency enerator Nel piping only per HSC §25281.5 3 <br />❑ 6. SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR §2636(a)(3)J. <br />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 />C]99. OTHER (Specify) <br />491.52 <br />490-53 <br />UST Response Plan (3/2008) 313 <br />