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UNDERGRO• STORAGE TANK MOORING PLAN For use by Unidocs Member Agencies or where rrpprowd by your Local Jurisdiction Authority Cited: Title 23 CCR Sections 2632(d)(1), 2634(a)(2), and 2641(/1) TYPE OF ACTION Eirl. NEW PLAN ❑ 2 CHANGE OF INFORMATION NMI PLAN TYPE ONITORING IS IDENTICAL FOR ALL LISTS AT THIS FACILITY. ^10� (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION FACILITY ID # (Agency Use Ordy) — — FACILITY NAMEZ9�11 FACILITY SITE ADDRESS Man. CITY Olr�To�I ate. H. EQUIPMENT TESTING AND PRE VENTIVE MAINTENANCE State law requires that testing, preventive maintenance, and calibration of monioring equipment (e g.. sensors. Pow, line kali detectors, etc.) be performed in ^0 accordance with the equipment manufacturers' instructions, "annually, ichever is more frequent. Such work must be performed by qualified personnel. MONITORING EQUIPMENT IS SERVICEDANNUALLY ❑ 99. OTHER (Specify): ^m. III. MONITORING LOCATIONS This monitoring plan most include a Site Plan showing the general tank and piping layouts and the locations where monitoring is performed (i.e.. location of each seruor, line leak detector, monitoring system control panel, etc.). ifym already have a diagram (e.g., current UST Monitoring Site Plan from a Monitoring System Certification form, Hazardous Materials Business Plan map, etc.) which slows all required information. include it with this plan. IV. TANK MONITORING MONI RING IS PERFORMED USING THE FOLLOWING METHOD(S): (Check all that apply) att°. 1. CONTINUOUS ELECTRONIC MONITORING OF ANK ANNULAR (INTERSTITIAL) SPACE(S) OR SECONDARY CONTAINMENT VAULT(S) SECONDARY CONTAINMENTS 1S' &raDRY ❑ b. LIQUID FILLED ❑ c. UNDER PRESSURE ❑ d. UNDER VACUUM Nil] PANEL MANUFACTURER: VEF%�E ��Of ^112- MODEL #: LEAK SENSOR MANUFACTURER: ^1M. MODEL #(S): 79 MIs. ❑ 2. AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SINGLE WALL TANK(Sl PANEL MANUFACTURER: MI6. MODEL #: MIT IN -TANK PROBE MANUFACTURER: ^Oe MODEL #(S): MM LEAK TEST FREQUENCY: ❑ a. CONTINUOUS ❑ IS. DAILY/NIGHTLY 0 a WEEKLY ^20. ❑ d. MONTHLY ❑ e. OTHER(Speciy). Mgr PROGRAMMED TESTS: ❑ a. .1 h. ❑ b.0.2 h. ❑ c. OTHER (S IPa'fyE Mai. 0 &p� g�P� MD. 3. INVENTORY RECONCILIATION ❑ a. MANUAL PER 23 CCR §2646 ❑ b. STATISTICAL PER 23 CCR §2646.1 _ 9/ M24 ❑ 4. WEEKLY MANUAL TANK GAUGING (MTG) PER 23 CCR §2645 TESTING PERIOD: ❑ a. 36 HOURS ❑ b. 60 HOURS M3. []6 INTEGRITY TESTING PER 23 CCR ^§26/4}.1 TEST FREQUENCY:/ANNUALLY ❑ b. BIENNIALLY ❑ c. OTHER(Speciy): ��,�� @'&.VISUAL MONITORING DONE: W?< DAILY ❑ IS. WEEKLY pte .r<�.y> .,A) ❑ 99. OTHER (Specify): ^� V. PIPE MONITORING MON TORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) ^Oo CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(SyTRENCH(FS) AND OTHER SECONDARY CONTAINMENT SECONDARY CONTAINMENT IS: ❑ a. DRY ❑ IS, LIQUID FILLED ❑ c. UNDER PRESSURE, ❑ d UNDER VACWM ^ul. PANEL MANUFACTURER:yE��L�P,ep � ^OZ MODEL #: //_ -S �• . r7 C� ^O1 LEAK SENSOR MANUFACTURER: M" MODEL#(S): ;79,A1490 --Wil ^Os' WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP (ke., TURBINE) SHUTDOWN? ❑ a. YES ❑ b. NO Mab WILL FAILUREIDISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a. YES ❑ b. NO ^02 5r2. MECHANICAL LINE LEAK DETECTOR (MLLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED MLLD MANUFACTURER(s): AU' MODEL #(S): ^u' ❑ 3. ELECTRONIC LINE LEAK DETECTOR (ELLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS ELLD MANUFACTURER: y�EDE,c' .fl9r�J�" ^N0 MODEL#: %L.S — .rte wl. PROGRAMMED LINE INTEGRITY TESTS: ❑ a. MINIMUM MONTHLY 02 g.p.h. ❑ IS. MINIMUM ANNUAL 0.1 g.p.h. ^H' -- WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a YES ❑ b. NO ^Ue, WILL ELLD FAILURFIDISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a. YES ❑ b. NO sw_ Q'4. INTEGRITY TESTING FREQUENCY: ��/ANNUALLY ❑ b. EVERY YEARS [I c. OTHER(Speciy) ^Ms- ❑ b.WEEKLYe ❑ TIME SYSTEM OPERATED— M� LY!'TEST VIS C. MIN. MONTHLY& EACH Mn S.UAL MONITORING DONE: a. DAILY •Requrts asx •iPaq ••Allowdfarmmiuriegdmaurid wvgmay eanfo.fid PWKantY D°RSC 4'-SUI.NaMI) ❑ 6. PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXEMPTION FROM MONITORING PER 23 CCR §2636(ax3) ❑ 7. NO PRODUCT OR REMOTE FILL PIPING 1S CONNECTED TO THE UST(s) ❑ 99.OTHER (Speciy) Mn UN -022A -1/5 www.unidocs.org Rev. 10/14/03