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BCE#12919 UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN- age l of 2) TYPE OF ACTION ❑1.NEW PLAN ® 2.CHANGE OF INFORMATION 490-1 PLAN TYPE ❑ I.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490-2 lbeck one item only) N 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(Sl LT 4-LUBRIZOL I. FACILITY INFORMATION FACILITY Ill#(Agency Use 0nly) BUSINESS NAME(Same as FACILD'Y NAME) Costco Gasoline(LOC.N0.1031) 3. BUSINESS SPTH ADDRESS tp3, 2440 Daniels Sheet CTl'Y Manlsea YI.EQUIPMENT TESTING AND:I'REVENTIVE MAINTENANCE' Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak deleclors,etc.)must be performed at the loquency specified by the equipment manufacturers'ins Wctiona,or annually,whichever is more trequcnq and that such work must be performed by qualified personnel. 27 CCR�2632,2634,2635,-2641L_-_ MONITORING EQU[PMF.NT IS SERVICED ® I.ANNUALLY ❑ 99.OTHER(Specif)•): 490'3• 490.36 ' IILMNI�'ORIGLOCATiONS 1.NEW ON SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. 2.SITE PLOT PLAN/MAP PR 2634)49a4 EVIOUSLY SUBMITTED. (23 CCR§2632, IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): ■ LCONTINUOUSELECTRONIC TANK MONITORING OF ANNULAR ttril 5I UIIAL)SPACE(S)OR SECONDARY--CONTAINMENT-49o5 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: ❑ a DRY © b.LIQUID FILLED ❑ c.PRESSURIZED [I d.TINDER VACUUM 4� PANEL MANUFACTURER: Veedx-Root atiai: _.__._ -- MODEL#: TLS350R 49LL5 LEAK SENSOR MANUFACTURER: Veedar-Root ^� 490-9. MODEL#(S 79 794330-303 2,AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL IANKISI (23 CCR§ 43) 490-11 _ PANELMANUFACTURER: 490-12. MODEL#: 490-1 _1N-T6I4K PROBE MANUFACTURER: 490.14' MODEL#iS): __ _ 4W15LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DA[LY/NIGHTLY ❑ c.WEEKLY _ 490-16 �_ ❑ d MONTHLY El M OTHER JSpocifyj; 490-17 PROGRAMMED TESTS: ❑ a0.1 gp.h. ❑ b.01 g.p.b. ❑ c.OTHER(Specify): +90.13 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490.19490-20 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 490-21 S.TANK INTEGRITY TESTING(23 CCR§2643.1): 490¢2 TEST FREQUENCY: ❑ a ANNUALLY 490-23 ❑ b.BIENNIALLY ❑ C.OTHER(Specify): 490.23 490-25 ❑99.OTHER(Specify): 190.26 i,V.PIPE MONITORING IS PERFORMED WING THE FOLLOWING METHODS (Check ell that apply) 1.CONTINUOUS MONITORING OF PIPEJ PIPING SUMPS)AND OTHER SECONDARY VISUAL ALARMS. (23 CCR§2636) CONTAINMENT WITH AUDIBLE AND 490-20- SECONDARY CONTAINMENT IS:❑a.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ®d UNDER VACUUM 490a9 PANEL MANUFACTURER: Veeder-Root #; TL535oR � +90--31 LEAK SENSOR MANUFACTURER_Veeder-Root _ 490.32 MODEL S: 794330-323.794390304,85728(1-tOp +900-3 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. _----1.----�-� '---' ®a.YES ❑b.NO 49x34 .MECHANICAL LINE TONLEA OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. N a.YES ❑b.NO 490.35 ■ 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT PLOW WHEN A LEAK IS DETECTED(23 CCR 2636 __ _ ____ ____ 490--36 MLLD MANUFACTURER(S): PE Petro 49o-n MODEL#(S): STP-MLDA � � wo-3s ❑ 3_ELRCTRONIC LINR LEAK DETECTOR(ELLD)THAT ROUTRV_ELY PERFORM_33.O g.p.h.ISAR TESTS (Z3 CCR§2636) 4yp-3y _ __.___ ELLD MANUFACTURERS) DO"+_°7 :- __ 490+1 PROGRAMMED IN LINE LEAK TEST: ❑ I.MINIMUM MONTHLY 0.2 g.p.h. [12.MINIMUM ANNUAL 0.1 --_-T.. -_.--+- ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. g p h 490.43 ❑a.YES ❑b.NO ELLD FAILNTE R ITY T ONN G ION49o4s TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490'N 4.PIPE INTEGRITY TESTING 49o4s TEST FRE UENCY ❑ a ANNUALLY b.EVERY 3 YEARS c.OTHER 5 ci S.VISUAL PIPE MONITORING. 49046 49047 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑c.MIN.MONTHLY&pACH TIME SYSTEM OPERATED. 49048 •AB.o dfam0vi ofu-1-diner c eneremr Nal 'in adX W HSC IMR15 3 49049 ❑ 6.SIICTTON PIPING MEETS EXEMPTION CRITERIA[23 CCR§26361 .. 49041 7•NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490-50 ❑ 99.OTHER(Specify) 490.51 190-53 UPCF UST-D(12/2007)I/4