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Alk <br />NOF UNIFIED PROGRAM CONSOLIDATED FORMW <br />UNDERGROUND STORAGE TANK <br />MONITORING PLAN - Pse 1 of 2) <br />49o-1 <br />TYPE OF ACTION . NEW PLAN ❑ 2. CHANGE OF INFORMATION <br />PLAN TYPE I. MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. <br />4904 <br />(Check one item only) ❑ 2. THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S)'- <br />1. FACHXff INFORMATION <br />FACILITY ID # (Agency Use Only)? <br />1 <br />3. <br />BUSINESS NAME (Same as FACILITY NAME <br />BUSINESS SITE ADDRESS OV, C I' CITY <br />t . <br />100 <br />II. EQUIPMENT STING AND PREVENTIVE MAINTENANCE <br />Testing, preventive maintenance, and calibration of monitoring equipment (e.g., sensors, probes, line leak detectors, etc.) must be performed at the frequency <br />specified by the equipment manufacturers' instructions, or annually, whichever is more frequent, and thm such work must be performed by qualified personnel. <br />23 CCR §2632,2634,2638,2641) <br />490.34 <br />MONITORING EQUIPMENT IS SERVICED 1. ANNUALLY ❑ 99. OTHER (Specify): <br />490.3E <br />III. MONITORING LOCATIONS <br />❑ 1. NEW SITE PLOT PLANIMAP SUBMITTED WITH THIS PLAN. SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR §2632, <br />2634)49oa <br />W. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): <br />I. CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR (INTERSTITIAL) SPACE(S) OR SECONDARY CONTAINMENT <br />490'5 <br />VAULT(S) WITH AUDIBLE AND VISUAL ALARMS. (23 CCR §2632,2634) <br />SECONDARY CONTAINMENT IS: a. DRY ❑ b. LIQUID FILLED ❑ c. PRESSURIZED ❑ d. UNDER VACUUM <br />490'5 <br />PANEL MANUFACTURER: 690'7'1 MODEL #: fffz= <br />490A <br />LEAK SENSOR MANUFACTURER: °90.9' MODEL #(S): <br />49 10 <br />2. AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SINGLE WALL FANKIS). (M CCR §2643) <br />490-11 <br />PANEL MANUFACTURER: 49°-12 MODEL #: <br />490-13 <br />IN -TANK PROBE MANUFACTURER: 49o -1a. MODEL#(S): <br />49°.15 <br />LEAK TEST FREQUENCY: ❑ e. CONTINUOUS ❑ b. DAILY/NIGHTLY ❑ c. WEEKLY <br />°9°'16 <br />C]d. MONTHLY ❑ e. OTHER (Specify): <br />490-17 <br />PROGRAMMED TESTS: ❑ a. 0.1 g.p.h. ❑ b. 0.2 g.p.h. ❑ c. OTHER (Specify): <br />490.18 <br />490.19 <br />❑ 3. MONTHLY STATISTICAL INVENTORY RECONCILIATION (23 CCR §2646.1): <br />490.20 <br />❑ 4. WEEKLY MANUAL TANK GAUGING (MIG) (23 CCR §2645). TESTING PERIOD: ❑ a. 36 HOURS ❑ b. 60 HOURS <br />°4�M <br />5. TANK INTEGRITY TESTING (23 CCR §2643.1): <br />°90-24 <br />490x4 <br />TEST FREQUENCY: [I a. ANNUALLY C] b. BIENNIALLY [3c. OTHER (Specify): <br />490-24 <br />490.26 <br />❑ 99. OTHER (Specify): <br />49027 <br />V. PII'E MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) <br />L CONTINUOUS MONITORING OF POE/ PIPING SUMP(S) AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND <br />490.26 <br />UAL ALARMS. (23 CCR §2636) <br />°90-29 <br />SECONDARY CONTAINMENT IS: a. DRY b. LIQUID FILLED ❑c. PRESSURIZED ❑d. UNDER VACUUM <br />. <br />PANEL MANUFACTURER: 490'30 <br />MODEL : �j <br />490-31 <br />49x32 <br />LEAK SENSOR MANUFACTURER: <br />MODEL #(S): <br />490.33 <br />PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP (i.e., TURBINE) SHUTDOWN. a. YES El b. NO <br />450-34 <br />�5 <br />vK4 <br />FAILUREIDISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. a. YES ❑ b. NO <br />490.35 <br />2. MECHANICAL LINE LEAK DETECTOR (MLLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF <br />PRODUCT FLOW WHEN A LEAK IS DETECTED CCR §2W <br />490-36 <br />MLLD MANUFACTURER(S): ' 490x7 MODEL #(S): <br />490.341 <br />❑ 3. ELECTRONIC LINE LEAK DETECTOR (ELLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS (23 CCR §1636) <br />490.39 <br />ELLD MANUFACTURER(S) 49 0, MODEL #(S): <br />490.41 <br />PROGRAMMED IN LINE LEAK TEST: ❑ 1. MINIMUM MONTHLY 0.2 g.p.h. ❑ 2. MINIMUM ANNUAL 0.1 g.p.h. <br />490°2 <br />ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a. YES ❑ b. NO <br />49043 <br />ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a YES ❑ b. NO <br />490-04 <br />4. PIPE INTEGRITY TESTING 490.4s <br />TEST FRE UENCY a ANNUALLY b. EVERY 3 YEARS c. OTHERS if 40.46 490.47 <br />5. VISUAL PIPE MONITORING. <br />490-141 <br />FREQUENCY ❑ a DAILY ❑ b. WEEKLY ❑ C. MIN. MONTHLY @ EACH TIME SYSTEM OPERATED' <br />490-49 <br />•Allo for nnonho, ofoo,00 dem m,, g0000duel pipiol My W HSC 25281.3 3) <br />❑ 6. SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR §2636(x)(3)1. <br />49050 <br />Ll 7. NO REGULATED PIPING PER HEALTH AND SAFETY CODE, DIVISION 20, CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM <br />490.51 <br />490.53 <br />❑ 99. OTHER (Specify) <br />490.53 <br />UPCF UST -D (12/2007) 1/4 <br />