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BCE #10199 UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN-(Page 1 of 2) TYPE OF ACTION I.NEW PLAN ❑ 2.CHANGE OF INFORMATION 4WH. PLAN TYPE 1.MONITORING IS IDENTICAL FOR ALL UST.AT THIS FACILITY. 4%4 (Check one Item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION FACILITY ID#(Agenn-Un Onh) 2, BUSINESS NAME(Same as Fac;lin'.Vame w DBA) s Coscto Gasoline 'Loc. No. 3B BUSINESS SITE ADDRESS 1616 Hammer Lane las, CITY Stockton II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)[oust be perfo reed at the frequency specified by the equipment manufacmma'instructions,or annually,whichever is mor:frequent.Such work must be perfomled by qualifed persannel.3z3 cCR 42632.2e ,163x.2M11 MONITORING EQUIPMENT IS SERVICED At least Od LANNUALLY Sif99.OTHER(Specify): per Mfrs. Instrs-4ww,-3.lfi9. . III. MONITORING LOCATIONS I.NEW S1TE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN ❑ 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED [v MR§1631 x6341 IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) ��`k i� 10 I.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) 4%s WITH AUDIBLE AND VISUAL ALARMS.[a Mftt363±,26341 SECONDARY CONTAINMENT IS: ❑ e.DRY b.LIQUID FILLED ❑ C.PRESSURIZED ❑ J.UNDER VACUUM 4WD'" PANEL MANUFACTURER: Veeder Root 4ww. MODEL#: TLS-35OR 4WX LEAK SENSOR MANUFACTURER: Veeder Root 0Nb9, MODEL a(s): 794380-301 4wr-I0. ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(Sl.rye 6sx g16q] +90-11. PANEL MANUFACTURER: i90.1z MODEL 4: IN-TANK PROBE MANUFACTURER: 690.1J- MODEL#(S): 4%4 15. LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ C.WEEKLY ° 46' ❑ d.MONTHLY ❑ e.OT14ER(Specify): 4%1.7. PROGRAMMED TESTS: ❑ a.0,1 g'p'h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): .. . . . . - __ - - ---_ _. ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION lzaccR 4x6+6.[] ._ _.. ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)[n MR 426451 TESTING PERIOD ❑ a.36 HOURS ❑ b.-60 HOURS 49p-''I' ❑ S.TANK INTEGRITY TESTING PER[n MR gze42.11 +�3).- TEST FREQUENCY: ❑ a.ANNUALLY ❑ b_BIENNIALLY ❑ c.OTHER(S_i Y4e 25 + L.I 99.OTHER ify): Tank Probe VR-847390-109; Ball Float 90% Capacity Fill Point ,�,M'-a 27 V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) 6nl11 all qpAijq I.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 4%628. 1126361 SECONDARY CONTAINMENT IS: +w1-rv. 4•-63fij [ad�e.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM PANEL MANUFACTURER: Veeder Root 440.22 MODEL 0: TLS-350R d00'21- LEAK SENSOR MANUFACTURER: _.Veeder Root 4sasz' MODEL#(S): * PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e..TURBINE)SHUTDOWN. El &YES ❑ b.NO FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. Of a.YES ❑ b.NO ❑ 2.MECHANICAL LINE LEAK DETECTOR(MELD)THAT ROl1TINELY PERFORMS 3.0 g.p.b LEAK TESTS AND RESTRICTS OR SHUTS OFF 490,'^ PRODUCT FLOW WHEN A LEAK IS DETECTED.(23 66x126561 MLLD MANUFACTURER(S): -ff °°2.11' _MODEL MSS): 491-5x. 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.123 MR§26361 4*I 39 ELLDMANUFACTURER(S): Veeder Root 49140. MODEL#(S): 848480-001 4w1-n. PROGRAMMED IN LINE LEAK TEST: ❑ a.MINIMUM MONTHLY 0.2 gF1. ❑ b.MINIMUM ANNUAL 0.1 gF.h. 4%x41. ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. G,--r/e.YES ❑ b.NO 4w 3 ELLD FAILURErDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ly o.YES ❑ b.NO °9p'4i -D INTEGRITY ...E _....... ......_........ ❑ 4.PIPE INTEGRITY TESTING. - - ------ � ��_��-�-+w2as. TEST FREQUENCY C3.a.ANNUALLY . 0 b.EVERY 3 YEARS ❑ : OTHERS 400606 __... ... .. ._....._... ._.....___ 4w42. ❑ S.VISUAL PIPE MONITORING. +%64x. FREQUENCY: ❑ A.DAILY ❑ b.WEEKLY ❑ C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 4w V, _._._. __. __.. _......__ .._.*Allwxd(w,rtowmtoa,o(maWe!-m yyn,mror 6rl.ClpviyoNY per_HSC q15?xI 51x431 ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA [±5 ccs 1106(99311 ~0 ❑ 7.140 REGULATED PIPING PER HEALTH AND SAFETY CODE DIVISION 20,CHAPTER 6.715 CONNECTED TO THE TANK SYSTEM. 4%1-51 [s1� 99.OTHER(Specify) *qll#II amps 8 vapor sumps have VRoot 112 sensors except Tank 1 187 octl fill sump has s VRW 352 sensor 4%693. UPCF UST-D(122007)-1/4 www.Reidxa.org