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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN- (Page 1 of 2) TYPE OF ACTION ❑ 1.NEW PLAN 2.CHANGE OF INFORMATION °90-1. PLAN TYPE 1rl.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 4902 (Check one item only) ❑ 2_THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S)- I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) 1. BUSINESS NAME(Same as Facility Nameor DBA) 3 37- o Edi• L A)r - BU IN S SITE PDRE /. 103. CITY II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)most be performed at the frequency specified by the equipment manufacturers'instructions..or annually,whichever i more frequent..Such work must be performed 63'qualified personnel.123 CCR§2632 2634.26.3.8,26411 MONITORING EQUIPMENT IS SERVICED YIANNUALLY ❑ 99.OTHER(Specify): 400-36. III. MONITO G LOCATIONS L NEW SITE PLOT PIAN/MAPSLIRMI I TFI)WTI"H'fHIS PLAN 2_SITFPIOTPI,AN/MAIIPREVIOUSI.YSUBMI"FEED JB0-4' ❑ [n CCR§z63A x6341 IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (h aekrl I 1,CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) 490-5. WITH AUDIBLE AND VISUAL ALARMS ID CCR§202,26341 SECONDARY CONTAINMENT IS: ❑ a.DRY &(b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 490-6 PANEL MANUFACTURER: O 490'9, MODEL#: S 490-8. LEAK SENSOR MANUFACTURER: EOL'-/dS 0&z 490-9. MODEL#(S): S'%Dg _490-10- _ ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SI GLE WALL TANK(SL ID CCR§x643] 490-n PANEL MANUFACTURER: 490-11 MODEL#: 490-13_ IN-TANK PROBE MANUFACTURER: 490.14. MODEL#(S): 490-15. LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILYINIGHTLY ❑ c.WEEKLY 490-16. ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-1' PROGRAMMED TESTS: ❑ a.0.1 h. ❑ b.0.2 h ❑ R ci 490-16. _. _ BSPg.p.h. C.OTHER S_ _- _- - - �R �'$ 90-19 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2M&,]] 490-20. ❑ 4 WEEKLY MANUAL TANK GAUGING(MTG)123 CCR§2645] TESTING PERIOD ❑ a.36 HOURS ❑ b 60 HOURS 4904-30-21. _ _._... --.._____- ___.._.-.._._..____- ___ _______. ...___-. ______-_ 11 ❑ 5.TANK INTEGRITY TESTING PER(23 CCR§2643.1] 4%-23 TEST FREQUENCY: ❑ a.ANNUALLY [Ib.BIENNIALLY E] c.OTHER(Specify): 490 z0-z4. ❑ 99 OTHER(Specify): 490-26 490-27 V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) ycaheack all I.CONTINUOUS MONITORING OF PIPE/PIPIN SUMP(S)AND OTHER SECONDARY CONTAINMENT WI IIF AUDIBLE&VISUAL ALARMS. 4%26 1§26361 SECONDARY CONTAINMENT 1$: Ip a.DR/Y4. ❑ bfLIQ�D F14yEp ❑ c.PRESSURIZED ❑ d.UNDER VACUUM °9°-0-9. PANEL MANUFACTURER: AEAe' 4ERT/O F�/Y.SC/_/� 9°-3° MODEL#: O S6oan LEAK SENSOR MANUFACTURER: ✓�F-GA MODEL#(S): PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ❑ a.YES .NO °4, FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. Ela.YES �.NO 49x35. ❑ 2.MECHANICAL LINE LEAK DETECTOR(MELD)THAT ROUTINELY PERFORMS 3.0&p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF 490-36 PRODUCT FLOW WHEN A LEAK IS DETECTED.ID CCR§26361 MLL_D MANUFACTURER(S): 990.31 MODEL#(S): 490-38. ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.ID CCRI2061 490-39_ ELLD MANUFACTURER(S): 490.40. MODEL#(S): 49041. PROGRAMMED IN LINE LEAK TEST: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. 490'41 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 d90.°°-Nj - 4.PIPE INTEGRITY TESTING , 49045. TEST FREQUENCY &(a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 0-q 0l 5 VISUAL PIPE MONITORING. 490'°8, FREQUENCY: V.DAILY ❑ b.WEEKLY ❑ C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED. 49 19. „_,.-_-__!_AII w %r moniron g f b_atemergenrygmeraror fuel Aping aN,�per HSC§252815(b)(3)_. 6 SUCTION PIPING MEETS EXEMPTION CRITERIA.ID CCR§2636()(3)) 490-50. ___--... _.... ....-.. -..__.___._-. __-._..__. _._.___-__- ___._. _..-__.__.__ .. _._.__.__- _. ❑ 7.NO REGULATED PIPING FER HEALTH AND SAFETY CODE DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490-51. ❑ 99.OTHER(Specify) completed mn n A 4 49 51 UPCF UST-D(I2/2007)-1/4 www.unidocs.org 1 011 pleted � YYY 1 1Y