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UNDERGR60ND STORAGE TANK MkITORING PLAN For use by Unidocs Member Agencies or where approved by your Local Jurisdiction Authority Cited: Title 23 CCR, Sections 2632(d)(1), 2634(d)(2), and 2641(h) TYPE OF ACTION ® 1.NEW PLAN ❑ 2.CHANGE OF INFORMATION MOL 'LAN TYPE ® MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. Moz. (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) FACILITY NAME FLAG CITY ARCO AM/PM Moa. FACILITY SITE ADDRESS 14931 North Flag City Blvd Mao CITY Lodi Mas II. EQUIPMENT TESTING AND 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 MMfl accordance with the equipment manufacturers'instructions,or annually,whichever is more frequent. Such work must be performed by qualified personnel. MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY ❑ 99.OTHER(Specify): Mm. 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,Hazardous Materials Business Plan ma ,etc.)which shows all required information,include it with this plan. TV. TANK MONITORING MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S):(Check all that apply) Mm. ® 1.CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) SECONDARY CONTAINMENT IS: Ir a.DRY ❑ b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM MIL PANEL MANUFACTURER: GILBARCO M12. MODEL#: FM_ C Mtn. LEAK SENSOR MANUFACTURER: �t��'LA dG ® MIC. MODEL#(S): [.J�OQ Mts. ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANKS) PANEL MANUFACTURER: MIs. MODEL MIT IN-TANK PROBE MANUFACTURER: Mlg. MODEL#(S): M19. LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILYINIGHTLY ❑ c.WEEKLY Mzo. ❑ d.MONTHLY ❑ e.OTHER(Specify): Mnl. PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): Mu. Mil. ❑ 3.INVENTORY RECONCILIATION ❑ a.MANUAL PER 23 CCR§2646 ❑ b.STATISTICAL PER 23 CCR§2646.1 MN ❑ 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: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ C.OTHER(Specify): Mz6. WT ❑ 6-VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(Require.ognnny.Arun,.) ❑ 99.OTHER(Specify): we V. PIPE MONITORING MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) Myo_ ® 1.CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(SyTRENCH(ES)AND OTHER SECONDARY CONTAINMENT SECONDARY CONTAINMENT IS: a.DRY ❑ b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM Mar PANEL MANUFACTURER:GILBAO M31 MODEL#: EMC M33. LEAK SENSOR MANUFACTURER: .J' q,/G PI Mia MODELMODEL#(S): �,O �j M35. WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN? �I�` WILL FAILURFIDISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? .YES YES ❑ b.NO M36, MECHANICAL LINE LEAK DETECTOR ❑ b.NO (MLLLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK ❑ IS jETEC MLLp fO �s MODEL#(S): Ptom'1 M39 3.3.ELECTRONIC LINE LEAK DETECTOR(FLLD)THAT ROUTINELY PERFORMS - 3.0 g.p.h.LEAK TESTS ELLD MANUFACTURER: Moo. MODEL#: M43. PROGRAMMED LINE INTEGRITY TESTS: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. Moz. WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO Moz WILL ELLD FAILURE/DISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M" ❑ 4.INTEGRITY TESTING TEST FREQUENCY: ❑ b.EVERY 3 YEARS ❑ C.OTHER(Specify) M45. M46. Q ❑ a.ANNUALLY 5.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY" ❑ C.MIN.MONTHLY,@ EACH TIME SYSTEM OPERATED"" mar. "Ra .ninnry sginn 1 ""AlbwWfor mnaoring ofunburied emergency genemtar fucl piping only mHSC§252g1.5(Mg]) ❑ 6.PIPING 1S 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) Mae. UN-022A-1/5 wvrw.unidoes.org Rev.10/14/03