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UNIFIED PROGRAM CONSOLIDATED FORM VF 10 UNDERGROUND STORAGE TANK MONITORING PLAN- Pae I of 2) TYPE OF ACTION ❑1.NEW PLAN 2.CHANGE OF INFORMATION 0-90-1 1r PLAN TYPE 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490-2 (Check one item only) 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S), I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) BUSINESS NAME(Same as FACILITY NAME) 3 BUSINESS SITE ADDRESS / �� „n �d. 10 CITY 206' H.EQUIPMENT TES G AND PREVENTIVE MAWMANdE 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 42632,2634 2638,264 1 490.3& MONITORING EQUIPMENT IS SERVICED I.ANNUALLY ❑ 99.OTHER(Specify): 49o3b III.MONITORING LOCATIONS i 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. L SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 34)49o-4 IV.TANK MONITORING IS PERFORMED USING TEE FOLLOWING METHOD(S): 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490-5 elz VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: 0 a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490.6 PANEL MANUFACTURER: . v 490.7 MODEL#: %r(- 49042 LEAK SENSOR MANUFACTURER: r 490-9 MODEL#(S): Z/-2-6 490-10 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S1.(23 CCR§2643) 0-90 21 PANEL MANUFACTURER: 490-11 MODEL#: 49013 IN-TANK PROBE MANUFACTURER: 490-14. MODEL#(S): 49015 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 49046 ❑ d.MONTHLY ❑ e.OTHER(Specify): 490.17 490-18 PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): 490-19 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490.20 [34.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a.36 HOURS El b.b.60 HOURS 490-22 zz 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 490-24 TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 490.25 490.26 ❑99.OTHER (Specify): 490.27 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check 0-H that apply) 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 428 VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS: DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d UNDER VACUUM °90 29 PANEL MANUFACTURER: 490-30 MODEL#: J*ft 490-31 LEAK SENSOR MANUFACTURER 490.32 MODEL#(S): 26jg 490-33 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ❑a.YES;'b.NO 490-34 FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a YES Xb.NO 0-90-35 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 DETE D 23 CCR 26 490.36 MLLDMANUFACTURER(S): ✓ 490-37 MODEL#(S):77-Zj:o2V o TP-M 490.3' ❑ 3.ELECTRONIC LINE LEAK DETECTOR( LLD)THAT ROUTINELY PERFORMS 3.0 g.p h.LEAK TESTS (23 CCR 62631 490-39 ELLD MANUFACTURER(S) 490'401 MODEL#(S): 490-41 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 FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 69044 4.PIPE INTEGRITY TESTING 49045 TEST FREQUENCY 1Z a.ANNUALLY b.EVERY 3 YEARS 0 c.OTHERS if 490-46490.47 5.VISUAL PIPE MONITORING. 19048 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED- 490-49 •Allowed for monilonag of unbwed emergency emaior fuel piping odv per HSC§25281.5(bX3) ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(a)(3)I. 490-50 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490-51 490--52 ❑ 99.OTHER(Specify) 490-53 UPCF UST-D(12/2007)1/4