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• i - SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT UNDERGROUND STORAGE TANK MONITORING PLAN - PAGE 1 TYPE OF ACTION 5. I. NEW PLAN ❑ 2. CHANGE OF INFORMATION Mol. PLAN TYPE Id MONITORING IS IDENTICAL FOR ALL LISTS AT THIS FACILITY. M02. (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S) I. FACILITY INFORMATION FACILITY TD 4 (Agency Use Only) FACILITY NAME Moa. FACILITY SITE ADDRESSQar�a M04. CITY ?� dMos. IL EQUIPMENT TESTING AN0 PREVENTIVE MAINTENANCE State law requires that testing, preventive maintenance, and calibration of monitoring equipment (e.g, sensors, probes, line leak detectors, etc.) be performed in 1106_ accordance with the equipment manufacturers' instructions, or annually, whichever is mom frequent. Such work must be performed by qualified personnel. MONITORING EQUIPMENT IS SERVICED W 1. ANNUALLY ❑ 99. OTHER (Specify): "101. III. MONITORING LOCATIONS This monitoring plan must include a Site Plan showing the general tank and piping layouts and the locations where monitoring is performed (i.e, location of each sensor, line leak detector, monitoring system control panel, etc.). If you already have a diagram (e.g., current UST Monitoring Site Plan from a Monitoring System Certification form, Iimixfous Materials Business Plan map, etc.) which shows all required information, include it with this Film. IV. TANK MONITORING MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): (Check all that apply) Mlo. 1. CONTINUOUS ELECTRONIC MONITORING OF OF TANK ANNULAR (INTERSTITIAL) SPACE(S) OR SECONDARY CONTAINMENT VAULT(S) SECONDARY CONTAINMENT IS: a. DRY ❑ b. LIQUID FILLED ❑ c. UNDER PRESSURE ❑ d. UNDER VACUUM On Mu PANEL MANUFACTURER: ye e d it R O d 7 M12. MODEL #: -r,4 S. ?.SD M13. LEAK SENSOR MANUFACTURER: f / 'e / o, M14. MODEL #(S): anl�_g' Al d M15. ❑ 2. AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SINGLE WALL TANK(S) PANEL MANUFACTURER: M16. MODEL #: Mn. IN -TANK PROBE MANUFACTURER: Pont MODEL #(S): M19. LEAK TEST FREQUENCY: ❑ a. CONTINUOUS ❑ b. DAILY/NIGHTLY ❑ c. WEEKLY M20. ❑ d. MONTHLY ❑ e. OTHER (Specify): M21. PROGRAMMED TESTS: ❑ a. 0.1 g.p.h. ❑ b. 0.2 g.p.h. ❑ c. OTHER (Specify): M22. M23. ❑ 3. INVENTORY RECONCILIATION ❑ a. MANUAL PER 23 CCR §2646 ❑ b. STATISTICAL PER 23 CCR §2646.1 M24. ❑ 4. WEEKLY MANUAL TANK GAUGING (MTG) PER 23 CCR §2645 TESTING PERIOD: ❑ a. 36 HOURS ❑ b. 60 HOURS M25. ❑ 5. INTEGRITY TESTING PER 23 CCR §2643.1 TEST FREQUENCY: ❑ & ANNUALLY ❑ b. BIENNIALLY ❑ e. OTHER (Specify): M26. M T ❑ 6.VISUAL MONITORING DONE: ❑ a. DAILY ❑ b. WEEKLY (Requbes agenq approval) ❑ 99.OTHER (Specify): Meg_ V. PIPE MONITORING MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) M30 LX1, CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(S)/TRENCH(ES) AND OTHER SECONDARY CONTAINMENT SECONDARY CONTAINMENT IS: JAI. a. DRY ❑ b. LIQUID FILLED ❑ c. UNDER PRESSURE ❑ d. UNDER VACUUM 'e'" PANEL MANUFACTURER: V9 B (I e e I c OO T M32- MODEL #: rL s- L S 6 W3. LEAK SENSOR MANUFACTURER: i Y /,, // M34_ MODEL #(S): 2 A J' Mas. WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP (i.e., TURBINE) SHUTDOWN? ❑ a. YES ❑ b. NO M36. WILL FAILUREMISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a. YES ❑ b. NO M32 ❑ 2. MECHANICAL LINE LEAK DETECTOR (MELD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED q MJ8 TLS SO M39. MLLD MANUFACTURER(s): MODEL #(S): . d 19 3. ELECTRONIC LINE LEAK DETECTOR (ELLD THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS FELL, MANUFACTURER: VEFI , It %1007, Moo MODEL#: M41, PROGRAMMED LINE INTEGRITY TESTS: at a. MINIMUM MONTHLY 0.2 g.p.h. 10 b. MINIMUM ANNUAL 0.1 g.p.h. M42. WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? X a. YES ❑ b. NO M43. WILL ELLD FAILUREMISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? @j a. YES ❑ b. NO M44. ❑ 4. INTEGRITY TESTING TEST FREQUENCY: ❑ a. ANNUALLY ❑ b. EVERY 3 YEARS ❑ c. OTHER (Specify) Mas. M46. ❑ 5.VISUAL MONITORING DONE: ❑ a. DAILY ❑ b. WEEKLY- ❑ C. MM. MONTHLY & EACH TIME SYSTEM OPERATED** M47. ' Requiresagenq*pmval " Allowed for monitoring of unburned emergency generator fuel piping only per HSC §15281.5(b)(3) ❑ 6. PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXEMPTION FROM MONITORING PER 23 CCR §2636(a)(3) ❑ 7. NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) ❑ 99. OTHER (Specify) M48. SJCEHD-d (07/03) - 1/4 0723/03