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r UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN-(Page I of 2) 490.1 TYPE OF ACTION ❑1.NEW PIAN FL 2.CHANGE OF INFORMATION 49x2 PLAN TYPE 1.MONITORING IS IDENTICAL FOR ALL USTS AT THIS FACILITY. (Check one item only) 2.THIS PLAN COVERS ONLY I FACTHE LOWIN INFOG UST RMATION FACILITY ID#(Agency Use Only) 3. BUSINESS NAME(Same as FACILITY NAME). L'9, Al .7Im. C G/ 104, BUSINESS SITE ADDRESSeN S, A 4 r 1� & K. ITY H.EQUIPMENT TESTING AND PRE NTF✓E MAINTENANCE Testing,preventive maintenance,and calibalion of monitoring equipment(e.g,sensors,probes,line leak detectors,etc.)must be performed al 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) '--- 490-5• MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY ❑ 99.OTHER(Specify): 690-3b M.MONITORING LOCATIONS ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 2634 90A W.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): 49x5 1.CONTINUOUS ELECTRONIC TANK MONITORING 0f ANNULAR(INTERSTITTAL)SPACES)OR SECONDARY CONTAINMENT VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) 4906 SECONDARY CONTAINMENT IS: a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM C 49-38 69xZ MODEL#: �7 -PANEL MANUFACTURER Qr !? --- °90-9' MODEL#(S):- - 9aio -- LEAK SENSOR MANUFACTURER: T 490-u 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 4W.13 490-12' MODEL#: PANEL MANUFACTURER: - 490-1s 690-14' MODEL#(S)• _ DJ-TANK PROBE MANUFACTURER_ -- 49-31-3 LEAK TEST FREQUENCY: E] a.CONTINUOUS [01b.DAILYMIGHTLY ❑ c.WEEKLY - _ 49an ❑ e.OTHER(Specify).__________-_____-d.MONTHLY - __ _ _ - 690-Is PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify); 490-19 490-20 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 0-21 F14.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: Ela.36 HOURS ❑ b.60 HOURS 490-214W22 9490-23 ❑ 5.TANK TEST FREQUENCY:O❑ a. STTANNUALLY NG(23 §23b' ❑BIENNIALLY c.OTHER(Specify): 490-2 49x255 490.26 ❑99.OTHER (Specify): 49axr V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHODS)(Check aH that apply) L CONTINUOUS MONITORING OF PIPE/PIPING SUMPS)AND OTHER SECONDARY CONTAINMENT W[TH AUDIBLE AND 49086 SUAL ALARMS. (23 CCR§2636) 490-29 SECONDARY_CONTAINMENT IS.:t..DRY ❑b.LIQUID FILLED Or.PRESSURIZED Ed.UNDERVACUUM _ _---_ 4�J1 Oso-3o MODEL ___ _ PANEL MANUFACTURER_V_ee--e. __ -_- _____ - = .. ^�! 49-3x0 n esuix MODEL#(S): {Q�U y[Q _ LEA_K SENSOR MANUFACTURER: (�Q �.f l� { ------- "'"-'- - 490-34 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN.. ❑a.YES ❑b.NO 49o-xs FAH,UREIDISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTO TIC PUMP SHUTDOWN. [Ia.YES ❑b.NO 2.MECHANICAL LINE LEAK DETECTOR(ML LD)THAT ROUTINELY PERF S 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED(23 CCR2636)-___ -_-____-_--{----_f- ---- °90-38 :1!&C-1: 49aat MODEL#(S): r O V MLLD MANUFACTURER(S): g.p.h. na on 490-39 ❑ 3.ELECTRONIC LINE LEAK DETECTOR(FLED)THAT RO NELY�PERFORNYS 3.0 LEAK TESTS (23 CCR§2 4�A1 aso<0. i MODEL#(S): ELLD MANUFACTURER(S) 490.42 PROGRAMMED IN LINE LEAK TEST: ❑ L MINIMUM MONTHLY 0.2 g.p.h. E] 2.MINIMUM ANNUAL 0.1 g.p.h. YES [Ib.NO °9043 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. 1:1a. 490-04 ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑e.YES El b.NO 4.PU'E INTEGRITY TESTING x90<s 490-0649x47 TEST FRE UENCY ❑ e.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER S ecif 49048 S 5.VISUAL PIPE MONITORING. FREQUENCY (3a.DAILY C3 b.WEEKLY c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED" ago<9 "Allowed for monuoring ofunbuded e.rpny genmwr fuel Eipinironly W HSC 25281.5 ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA l23 CCR§2636(a)(3)l. 49x50 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 :, CONNECTED -b THE TANK SYSTEM 490-51 490-52 ❑ 99.OTHER(Specify) ago-53 r UPCF UST•D(12/2007)1/4