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UNIFIED PROGRAM CONSOLIDATED FORItWVF UNDERGROUND STORAGE TANK MONITORING PLAN-(page I of 2) TYPE OF ACTION ❑1.NEW PLAN l5 2.CHANGE OF INFORMATION PLAN TYPE 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 4WI (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEMS) I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) BUSINESS NAME(Same as FACILITY NAME) < ILL G s BUSINESS SITE ADDRESS I )•) a� 1Qu CITY 1N. IL 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 is more frequent,and that such work must be performed by qualified personnel. 23 CCR§2632,2634,2638,2641 MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY ❑ 99.OTHER(Specify): 4 h HI. ONTTORING LOCATIONS ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. [9 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2672, 2634)4904 IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAUN[MNT 49 3 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 4906 PANEL MANUFACTURER: moi.en-OA, s.^' 49o-9. MODEL#: ( - G 4903 LEAK SENSOR MANUFACTURER: I T c 4969. MODEL#(S): z-L 49610 -CF2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(31.(23 CCR§2643) 49 11 PANEL MANUFACTURER: 090'12 MODEL#: 49613 IN-TANK PROBE MANUFACTURER: 4WR MODEL#(S): 49613 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILYINIGHTLY ❑ c.WEEKLY 490716 ❑ d.MONTHLY ❑ e.OTHER(Specify): 49 17 PROGRAMMED TESTS: ❑ c 0.1 g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): �9 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 49626 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a 36 HOURS ❑ b.60 HOURS 44W2211 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 49 D TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 49 N 490.29 ❑ 99.OTHER (Specify): 490.E 490.27 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) .CONTINU OUS UOUSMONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 49628 ISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS: .DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM 49069 PANEL MANUFACTURER c a90'so MODEL#: '-' 1 4Wn LEAK SENSOR MANUFACTURER: ( ( d90.22 MODEL#(S): 49633 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. P;a YES ❑b.NO 49 M FAILUREIDISCONNECITON OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. a YES ❑b.NO a9o-ss 2.MECHANICAL LINE LEAK DETECTOR(MILD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TES AND RESTRICTS OR SHUTE OFF PRODUCT FLOW WHEN A LEAK IS DETECTED 23 CCR 4WM i MLLD MANUFACTURER(S): �, 1 `37 MODEL#(S): .S'1 4 -.t ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT RO LY PERFORMS 3.0 g.ph.LEAK TESTS (23 CCA§ 49639 ELLD MANUFACTURER(S) 49040' 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. 49042 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490'93 ELLD FAILUREIDISCONNECTION TRIGGERS AUTOMATIC POMP SHUTDOWN. ❑a YES ❑b.NO 49040 4.PIPE INTEGRITY TESTING 49043 TEST FREQUENCY El a ANNUALLY b.EVERY 3 YEARS c.OTHERS i 49a46490.4f 5.VISUAL PIPE MONITORING. 490.16 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY A EACH TIME SYSTEM OPERATED- 49049 •a1o.,e ror moat - otalw�0a mnew rel 1 w xsc U2st.s ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(ax3)1. 490.10 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6715 CONNECTED TO THE TANK SYSTEM 490.51 ❑ 99-OTHER(Specify) 490.32 40.33 UPCF UST-D(122007)IN