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UNIFIED PROGRAM CONSOLIDATED FORM D UNDERGROUND STORAGE TANK n 1� MONITORING PLAN-(Page 1 of 2) TYPE OF ACTION ❑ 1.NEW PLAN 2.CHANGE OF INFORMATION APR 0 1 2009 490-1 PLAN TYPE t.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490-2 (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEMS) ENV1RONMEN T 4FA1 TH I. FACILITY INFORMATION P-HNIN USERVICES FACILITY ID#(Agency Use Only) -1 1 1 1 1 1 11 BUSINESS NAME(Same as FACILITY NAME) 4kAAC& J a S h, C30) To S e F 1 3 BUSINESS SITE ADDRESS -�� S �E�I+CL7 I°3. CIT S �,� � I(u. II.EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must be performed at 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)__ MONITORING EQUIPMENT IS SERVICED {e 1ANNUALLY ❑ 99.OTHERS ci 490-3 UIPMENER . b Q ( � �)� 490-3b III.MONITORING LOCATIONS 6'1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 34)4904 IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490-5 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: LJ-1.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 4N0-6 PANEL MANUFACTURER: ( 490 I MODEL#: 1. S 3Sb 490.8 - - --- --- - ------ --� - -- --------------------------- - - --T-------------T----DEL#---- LEAK SENSOR MANUFACTURER: �- 490-9 1 MODEL#(S): 490-10 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 490-11 PANEL MANUFACTURER: _ 490-12. MODEL_#: 490-13 -------------IN-TANK PROBE MANUFACTURER---- 490-14.-----------------MODEL#(S): -------------------------- 490.15 ---------------------------------------- LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490-16 ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17 -------------------------------------------------------------------------------------------------------------------------------------------------- PROGRAMMED TESTS: ❑ a.0.1 h. ❑ b.0.2 h. ❑ c.OTHERS ci 490-19 g.p.h. g�P� (Specify): 490.19 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490-20 ED 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: [:] a.36 HOURS ❑ b.60 HOURS 4v 0-22 ❑ 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 TEST FREQUENCY a.ANNUALLY [:1b.BIENNIALLY ❑ c.OTHER(Specify): 49900-z5 ❑99.OTHER (Specify): a 0-27 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490.28 VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS:[Za.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM 490-29 -- PANEL MANUFACTURER: 4131 1 MODEL#: 490-31 ------------------------------------ - ---- 490-32t---_-----' ��1 (' 4�XI-33 - LEAK SENSOR MANUFACTUREfi_-------------------------- - ------ ---1-MODEL#(S)_---1��3 iJ ----------------- -- PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. 01a.YES ❑b.NO 490-34 FAILUREMISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. aaYES ❑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 FLOW WHEN A LEAK IS DETECTED(23 CCR§2636 __----- __ __..................................... 490-36 -- MLLD MANUFACTURER(S): 490-37 MODEL#(S): 490-38 ❑ 3. ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.b.LEAK TESTS (23 CCR§26305 r490-39 --------------------------------------------------- -----------------------49040.----•-•-•----------,------------------------------------- 490.41 ELLD MANUFACTURER(S) 1 MODEL#(S)_----- PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. 49042 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490-43 ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490-44 ❑ 4.PIPE INTEGRITY T&STING 490.45 TEST FREQUENCY-laa.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 490-46490.47 5.VISUAL PIPE MONITORING. 490.48 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED- 49049 'Allowed for monitoring of unburied emerjtene gmerwor fuel pipingonh per HSC§25281 5(6)(3) ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(ax3)1. 490-50 ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490.51 ❑ 99.OTHER(Specify) 490-52 490-s3 UPCF UST-D(12/2007)1/4