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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT UNDERGROUND STORAGE TANK MONITORING PLAN -PAGE 1 TYPE OF ACTION '1.NEW PLAN ❑ 2.CHANGE OF INFORMATION Mol PLAN TYPE YMONITORING IS IDENTICAL FOR ALL UST.,AT THIS FACILITY. M02 (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) FACILITY NAME i ��S� M03 FACILITY SITE ADDRESS S 7 7 M04. CITY t G/, (MV,, Mos II. EQUIPMENT TESTMG 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 Mob accordance with the equipment manufacturers'instructions,or annually,whichever is more frequent. Such work must be performed by qualified personnel MONITORING EQUIPMENT IS SERVICED lid'1.ANNUALLY ❑ 99.OTHER fY) (S eci N107. (Specify): 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 map,etc.)which shows all required information,include it with this plan. IV. TANK MONITORING MO ORING IS PERFORMED USING THE FOLLOWING METHOD(S):(Check all that apply) M10 7I.CONTINUOUS ELECTRONIC MONITORING,OF TANK ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) 2< SECONDARY CONTAINMENT IS: 2 a. DRY ❑ b LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM N111 PANEL MANUFACTURER: I A— a T v fi M12. MODEL#: �� 3 SU N113 LEAK SENSOR MANUFACTURER )c J'r M14 MODEL#(S): M15. ❑ 2. AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S) PANEL MANUFACTURER: M16 MODEL#: N117 IN-TANK PROBE MANUFACTURER: M18 MODEL#(S): M19 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILYINIGHTLY ❑ c.WEEKLY N120 ❑ d.MONTHLY ❑ e.OTHER(Specify): M21 PROGRAMMED TESTS: ❑ a.0.l g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): Naz. 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: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): Mee N127 ❑ 6.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(Requires agency approval) ❑ 99.OTHER(Specify): '128 V. PIPE MONITORING MO F!IORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) N130 I.CONTINUOUS ELECTRONIC MONITORING OF IPING SUMP(S)/TRENCH(ES)AND OTHER SECONDARY CONTAINMENT SECONDARY CONTAINMENT IS: DRY ❑ b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM No 1. PANEL MANUFACTURER: A O O M" MODEL#: SLS .3 SV N133, LEAK SENSOR MANUFACTURER: Mia. MODEL#(S): M35 WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN? 5, a/.YES El b.NO M36 WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SI IUTDOWN? lea.YES ❑ b.NO M37 g/1 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 1,S DETECTED /J MLLD MANUFACTURER(s):VM_Z hjj4 l ri,' YL(Y�T M38 MODEL#(S):�D�(Z 1 I�/�IGp '�13a ❑ 3 ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT R UTINELY PERFORMS 3.0 g.p.h.LEAK TESTS ELLD MANUFACTURER: M40 MODEL#: _ N141 PROGRAMMED LINE INTEGRITY TESTS: ❑ a.MINIMUM MONTHLY 0.2 g.p.K ❑ b.MINIMUM ANNUAL 0 1 g p h N142 WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b NO 11143 WILL ELLD FAILURE/DISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO 11144 ❑ 4.INTEGRITY TESTING TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) N45 N146 ❑ 5.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY' ❑ c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED" %147 "Requires agency approval -Allowed for monitoring of unbuned emergency generator fuel piping only per HSC§25281 5(b)(3) ❑ 6 PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXEMPTION FROM MONITORING PER 23 CCR§2636(x)(3) ❑ 7.NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) ❑ 99.OTHER(Specify) N148 SJCEHD-d(07/03)-1/4 07/23/03