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'IIFIED PROGRAM CONSOLIDATED FORM UNDERGROUNDSTORAGETANK MONITORING PLAN- Pae 1 of 2) TYPE OF ACTION ❑1.NEW PLAN [12.CHANGE OF INFORMATION 400-1 PLAN TYPE 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 4902 (Check one item only) ❑ 2 THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEMS) I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) _ _ 1 BUSINESS NAME(Same as FACILITY NAME) IL O C L1��'� L llyN� 3. BUSINESS SITE ADDRESS Zj0 CJ Q. en `� H.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 most be performed by qualified personnel. 23 CCR J26322 26342635.2641) MONITORING EQUIPMENT IS SERVICED Dr I.ANNUALLY490.34 ❑ 99.OTHER(Specify): 490-36 III.MONITORING LOCATIONS I.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. ❑2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 634)490-0 IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): 10 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTFFIAL)SPACE(S)OR SECONDARY CONTAINMENT 49x5 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) ------ '--- SECONDARY CONTAINMENT IS: .p,_a.DRY [Ib.LIQUID FILLED ❑ C.PRESSURIZED ❑d.UNDER VACUUM 490'6 ----------- 4M7 49M '--"---- 49M PANEL MA_N_UF'ACTURE__ 11 -�M Lr, -_--__ ,t�/;�I{-tr,1... n___ _ LEAK SENSOR MANUFACTURER. e_Q 0 °90'9 MODEL#(S):'/ I '7 ' I/ 490-16- 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 490-11 PANEL MANUFACTURER. 490-12. 490-13 - MODEL#: IN-TANK PROBE MANUFACTURER__- _ - _490'14__MODEL#(S): 49015 ❑ LEAK TEST FREQUENCY a.CONTINUOUS ❑ b.DAILY/NiGHTLY ❑ c.WEEKLY 400'16 _ ❑ d.MONTHLY e.OTHER(§pecify):- -49017 PROGRAMMED TESTS: ❑ a.0.1490-13 g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): 494-19 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 49azo ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 490-21 490.2222 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490v TEST FREQUENCY. ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 49-24 490.25 [199.OTHER (Specify): 490-26 490-27 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 49-28 VISUAL ALARMS (23 CCR§2636) SECONDARY CONTAINMENT IS:❑a.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM 490-29 PANEL_MANUFACTURER. _ 494-)0 MODEL#: 490-31 _-_LEAK SENSOR MAN_UFAC_TURER__-_.-___.-____-_- PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(fe,TURBINE)SHUTDOWN. i ❑a.YES ❑b.NO 490-34 FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49-35 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF -_PRODUCT FLOW WHEN ALEAK IS DETECTED 23 CCR 12636-_-._-____- -- -_ -_ _ --_ 446 MLLD MANUFACTURER(S): Q Crr _ 49-38E _ - ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490.39 49-40 ELLD MANUFACTURER(S) - _1 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. 494'42 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES [__1 b.NO 40-43 ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49-44 4.PIPE INTEGRITY T S ING 49-45 TEST PRE UENCY a.ANNUALLY -] b.EVERY 3 YEARS ❑ c.OTHER S(Specify)) 490.46490-47 ❑ 5.VISUAL PIPE MONITORING. 49-48 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED- 490-49 •AlbwW for moniro ng ofunbunW em en2y jimernw fuel Pi Ping mly MrHSC 25281.5 ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA[23 CCR§2636(x)(3)1. 49o-so ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490-51 ❑ 99.OTHER(Specify) 490-52 490.53 UPCF UST-D(12/2007)1/4