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LVI:, H1V1JJ UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN- Pae 1 of 2 TYPE OF ACTION L NEW PLAN ❑ 2.CHANGE OF INFORMATION 490-1. PLAN TYPE 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490-2. (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): 1. FACILITY INFORMATION FACILITY ID#(Agency Use Only) L BUSINESS NAME(Same as Facility Name or DBA) 3. Coscto Gasoline Loc. No. 38 BUSINESS SITE ADDRESS 103 1616 Hammer Lane Grry Stockton � H. 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 equpment manufacturers'instructions or amually,wttichever is more frequent.Such work must.be perfotmed�quali lcd personnel Iz3 cca§?632,2634,2638,2641] �/ 490.3.. MONITORING EQUIPMENT IS SERVICED At least Lq I.ANNUALLY �r 99.OTHER(Specify): Per Mfrs . Instr8.490-36. IH. MONITORING LOCATIONS I.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN ❑ 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED (23 CCR 42632.26341 4904. IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Ch"k all that apply) I.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) 496-5. WITH AUDIBLE AND VISUAL ALARMS.[23 CCR§202,26M) SECONDARY CONTAINMENT IS: ❑ a.DRY b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 490.6. PANEL MANUFACTURER: Veeder Root 490.1. MODEL#: TLS-35OR 090$' LEAK SENSOR MANUFACTURER: Veeder Root 490A. MODEL#(S): 794380-301 49040. ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).[n cca 420431 49o-u. PANEL MANUFACTURER: 49.12. MODEL#: 490'13. IN-TANK PROBE MANUFACTURER: 490-14. MODEL#(S): 490-15. LEAK TEST FREQUENCY: ❑ &CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490.16. ❑ d.MONTHLY ❑ e.OTHER(Specify): 490.19. 4918. _ __ PROGRAMMED TESTS: ❑ a.0.l�e_h: _ _❑ b.0.2 g.p.h. ❑ a.OTHER(Specify): _49 19,_ ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION[ntxal2 .0 490-20. ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR 42645] TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 49.23. K INTEGRITY TESTING PER I23 CCR 42643.11 49°'23. _ _TEST FREQUENCY:; y_ [;rit ANNUALLY�❑ b.BIENNIALLY ❑ c.OTHER(S e�cify)_ 49 24_ 99.OTHER(Specify): Tank Probe VR-847390-109; Ball Float - 901f Capacity Fill Point <9oi.z6. V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (h l a`k ly) 56 I.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 490-z0.. [g36M1 SECONDARY CONTAINMENT IS: 6r a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 49.29. PANEL MANUFACTURER: Veeder Root 49.30. MODEL#: TLS-35OR 490.31. LEAK SENSOR MANUFACTURER: Veeder Root 49.32. MODEL#(S): 7943 _ 490.33. PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. a.YES ❑ b.NO 490'34. ,./ FAILURE(DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. [_I a YES ❑ b.NO 49.33. ❑ 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.ph.LEAK TESTS AND RESTRICTS OR SHUTS OFF 490.36. PRODUCT FLOW WHEN A LEAK IS DETECTED.(z3 CCR42636] MLLD MANUFACTURER(S): 49.37. MODEL#(S): 49.38. __-_ _..- _. ._.. 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.[D CCR426M] 490-39. HLLDMANUFACTURER(S): Veeder Root 49.x0. MODEL#(S): 848480-001 49.41' PROGRAMMED IN LINE LEAK TEST: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. 4go'42. ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. Gr&YES ❑ b.NO 490'43. ELLD FAILUREIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. 9a.YES ❑ b.NO 49044 Is EINTEGRITY TESTING. ---_ _ _ ��tn��-�� 49043. -_,____ TEST FREQUENCY___ 56 NNUALLY b.EVERY 3 YEARS C.OTHER(S 1 )_ _49 7. - - �__ 0_ __ ❑ 5.VISUAL PIPE MONITORING. 49048. FREQUENCY: ❑ a.DAILY ❑ b.WEEKLY ❑ C.MM.MONTHLY&EACH TIME SYSTEM OPERATED- 49049. Allo for owoionaa of unbuded 4oarR4^9'_Vamtor fuel Y1252al.3rox3) _... ❑ 6.SUCTION PIPING MEETS_EXEMPTION CRITERIA.(23 CCR 42636(a)(3)) 49.1. ❑ 7.NO REGULATED PIPING PER HEALTHAND SAFP�TY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM. 490x1. ❑ 99.OTHER(Specify) __ ----_ _ --___490.52. 49.53. UPCF UST-D(12/2007)-114 tvww.unidocs.org