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10/03/2007 09:41 <br />#0050 P.010 /021 <br />UPCF UST -D (I2 Mn V4 <br />UNIFIED PROGRAM CONSOLIDATED FORM <br />UNDERGROUND STORAGE TAMC <br />MONITORING PLAN - Pap I of 2) <br />TYPE OF ACTION p 1. NEW PIAN . CHANGE Of INFORMATION <br />490.1 <br />{ PLAN TYPE i . MONITORING IS IDENTICAL EOR ALL USTs AT THIS FACILITY. <br />4904 <br />(Check one itch onl _ ® 2. THIS PIAN COVERS ONLY THF, FOLLOWING UST SYSTEM -,)- <br />L FACILM INFORMATION <br />FACILITY I # (Agency Use Only) <br />, <br />BUSINESS NAME (Same as FACILITY NAME)3. <br />A -C -t 9 <br />• I3IJSiNE55 SITE ADDRESS iO3 CITY <br />10-4. <br />Uo� 1 <br />IL EQUIPMENT-TESMG' AND PREVENTM MAINTENANCE <br />Testing, preventive maintemmce, and calibration of monitoring egaipmettt (e.&, sensors: probM I ine leak dtte:etors, etc.) must be performed at the ftequecy <br />specified by the equipmrnt matmfacwters' instructions, or wtitually. whichever is more fregwent, and tat such work Must be perfomted by 4ud3fied Personnel. <br />23 CCR §2632, 2634, 2638., 2641 <br />MONITORING EQUIPMENT IS SERVICED 1. ANNUALLY ® 99. OTHER (Specify): <br />4�3b <br />III. MONITORING LOCATIONS' . <br />❑ I. NEW SITE PLOT PLAN/MAP SIJBMITTED WITTI TILLS PLAN_ 2_ SITE PLOT PREVIOUSLY SURMITtED. (23 CCR §M32, <br />i 2634 <br />IV. TANK MONITORING LS D'USING TM FOLLOWING OD(S): <br />1. CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR ) SPACE(S) OR SECONDARY CONTAINMENT <br />4969 <br />I YAULT(S) WITH AUDIBLE AND VISUAL ARMS. (23 CCR §2632, 2634) <br />1.....m SECONDARY CONTAINMENT IS: a. DRY ❑ b. LIQUID FILLED ® c. PRESSURI7ED ❑ d. UNDER VACUUM <br />49" <br />PANEL MANUFACTURER MODEL <br />LEAK SENSOR MANUFACTURER. 'ki� �� 4'0 7 MODEL #(Sy T1 <br />490 -10 <br />2. AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SINGT.E WALL TANK(SL (23 CCR §2643} <br />990.01 <br />i PANEL_ MANUFACTURER: 490-1Z MODEL. #: <br />4W13 <br />f IN -DANK PROBE MANUFAC_TURhKa 496.14' MODEL #(S): _ <br />�❑ -T <br />490.Is <br />LEAK TEST FREQUENCY: a. COR N OUS ❑ b. DAILYINIGHTLY ® C. WEEKLY <br />490.16 <br />d MONTM.Y ❑ e. OTHER (Specify): _ <br />496.17 <br />e <br />PROGItAMMAD TESTS:❑ s. 0.1 g.p,h, ❑ b. 0,2 ul. ❑ c. OTHER (Specifyy <br />4 0.19 <br />490.19 <br />Q 3.14IONTHLY STA:rISTICAL IbaVENTORY RECONCiLYAT[ON (23 CCR §26C6.I): <br />490-20 <br />Q 4. WEEKLY MANUAL TANK GAUGING (MTG) (23 CCR $2645). T'ISTING PERIOD: ®a. 36 HOURS ® b. 60 HOURS <br />=2i <br />5. TAMC INTEGRITY TESTING (23 CCR §2643.I): <br />23 <br />TFST FREQUENCY: ❑ a. ANNUALLY ❑ b. BIENNIALLY ❑ e. OTHER (S �,j <br />I'1.7 )' <br />490-=4 <br />4925 <br />Q 99. OTHER (Specify): <br />4W26 <br />a�27 <br />V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING THOD(9) (Check an the ) <br />ILL . COINTINUOUS MONITORING OF PIPE/ PIPING SUNP(S) AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND <br />490- <br />AL ALARM& (23 CCR ¢2636) <br />SIMNDARYC0NTATNMENTIS:Mi1DRY ❑b. LIQUID FILLED 0c.PRESSURIZED pd IJNDF.R VACUUM <br />450 29 <br />PANEL MANUFACTURER: E_ 4M30 MODEL. #; - , <br />49031 <br />I TEAK SENSOR MANUFACTURER _LL7"t� 49932 MODEL #(S): <br />PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP (Le_ TURBINR) SKM)OWN. r.... 1,7' r. YES ® b, NO <br />FAILUREADISCONNECTION OF THE MONNOR.ING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN.a. YES ❑ b. NO <br />4W35 <br />❑ 2. MECHANICAL LINE LEAK DETECTOR (MLLD) THAT ROUTINELY PERFORMS 3.0 g p.6. LEAK TESTS AND RESTRICTS OR SHUTS OFF <br />PRODUCT FLOW WHEN A LEAK IS DETECTED 23 CCR <br />490.26 <br />f MLLD MANUTACTURER(S): M % 490`37 MODEL #(S): s a9o-� <br />® 3. ELECTRONIC LINE LEAK DETECTOR (ELLD) THAT ROUTINELY PERFORMS 3A f p_ L LF.AIC TESTS (23 CCR §2636) <br />a9aD <br />ELLD MANIUFACTCIRER{S) 590 I MODEL u{S} <br />4`"'41 <br />PROGRANMD IN LINE LEAK TEST: ❑ I. MINIMUM MONTHLY 0.2 g.p.h. ❑ 2, MINIMUM ANNUAL 0,1 S.p.h. <br />49042 <br />FII.D DE LCTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. G] a. YES ❑ b. NO <br />490-0 <br />ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a. YES ❑ b. NO <br />49p4a <br />❑ 4. PIPE INTEGRITY TES'T'ING 49645 <br />j TEST FRE UENCY a. ANNUALLY ❑ b. EVERY 3 YEARS c. OTHER 4W46490.47 <br />5. VISUAL PIPE MONITORING. <br />496.44 <br />FREQUENCY ❑ a. DAILY ❑ b. WEEKLY Q c. MN. MONTHLY & EACH MME SYSTfu OPERATED' <br />490-49 <br />•Nlaarodi>xmp0go0emoralburiai 4ed cad t� I.stp zl <br />❑ 6. SUCTION PIPING MEETS EXEMP'T'ION CRITERIA 123 CCR §2636(a)(3)I. <br />490.50 <br />i T NO REGULATED PIPING PER HEALTH AND SAFE'L'Y CODE, DIVISION 20. CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM <br />49M.S1 <br />(Specify) <br />Pw 52 <br />4X3.5; <br />UPCF UST -D (I2 Mn V4 <br />