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L UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN— Pae 1 of 2) TYPE OF ACTION ❑ I.NEW PLAN ❑=OF INFORMATION +^ � PLAN TYPE C}i'IGONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. + � (Check one item onh) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION FACILITY ID q(Ageucv Use Oniv) n B (NESS NAME(Same as Facili(v Name or DBA) 3 v 4 r t rIq Kkujq .ar A e cr .- BUST ESS SITE DRESS 1�'3 CITY uu c' t • -a 5 ce �'zo 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 freguent_Such w_o_r_k_must he performed by quaI fled personnel 123.CCR g r 3 1X3+263,x m I MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY ❑ 99 OTHER(Specify). 4'X.3, m.3b III. MONITORING LOCATIONS ❑ L NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN C72.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED In CCR 4M3`_xa+I °XH IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) h he k`ll CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) +1X1-5 WITH AUDIBLE AND VISUAL ALARMS.In CCR S26Sx'-63q SECONDARY CONTAINMENT ISS 2-a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM PANEL MANUFACTURER: t1scpi A 41N17 MODEL k: LEAK SENSOR MANUFACTURER: Ows d YX4° MODEL N(S): L 02.Al7fOMATIC TANK GAUG ING(ATG)SYSTEM USEDOMONITORSINGLP.WALL AN KIS).I23 CCR g2w31 PANEL MANUFACTURER: 4"'42 MODEL N: 4w`u IN-TANK PROBE MANUFACTURER: 4,A"4 MODEL fl(S): +1XH5 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b,DAILY/NIGHTLY ❑ c.WEEKLY 49iW6 ❑ d.MONTHLY ❑ e.OTHER(Specify): 49`17 PROGRAMMED TESTS. ❑ a 01 h b 02 .h cOTHER(S If )_ 41X1I9 — ___...—..... ..__. g_p _.�... S:P ❑ . _P_aY 41X.19. ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION R3ccitpMu. I - ❑ 4.WEEKLY MANUAL TANK GAUGING(M"FG)I23CCRUW51 l LS I ING PERIOD: ❑ a 36 HOURS [3b,60 HOURS 4XI-21 ❑ 5 TANK INTEGRITY TESTING PER 121PCR§21.4311 491- TEST FREQUENCY ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c OTHER(Specify)_ 41v x.-+ ❑ 99.OTHER : +921' V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (check-" I.CONTINUOUS MONITORING OF PIPE/PIPING UMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. "w 28 In 26CC361 R SECONDARY CONTAINMENT IS'. a.DRY [Ib.LIQUID FILLED [I c.PRESSURIZED ❑ d.UNDER VACUUM 4'X"-9 8 PANEL MANUFACTURER: z"At r!v.f. 4Y1*30 MODEL M: X _145 +X.31 S LEAK SENSOR MANUFACTURER: 040%.VJ X9432' MODEL p(S): i - +9'u3 PIPING LEAKALARM TRIGGERS AUTOMATIC PUMP(i.c.,TURBINE)SHUTDOWN. ❑ a.YES /b NO +1X434 FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. [3a.YES F b.NO 4'X''33 2.MECHANICAL LINE LEAK DETECTOR(MELD)TFIAT ROUTINELY PERFORMS].0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF +'N43R PRODUCT FLOW WHEN A LEAK IS DETECT))I23Cmw361 tY/ +1X_37 ST +,Xr-3n MILD MANUFACTURER(S): i�E. F 'T'r't3 MODEL#(S): SI`P.yLJ�' �� ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.I'-3ccRt'1,361 41X1-3" ELLD MANUFACTURER(S): 491 nl MODEL M(S): 4.1.41 PROGRAMMED IN LINE LEAK TEST: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. 11442 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO +1XH3 ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO am�a [}4.PIPE INTEGRITY TESTING. TEST FREQUENCY: Ly-a ANNUALLY _ Cb EVERY 3 YEARS ❑ c.OTHER(Specify) J1X4,1Xw ❑ 5.VISUAL PIPE MONITORING. 41X'1, FREQUENCY: C1.DAILY [3 b.WEEKLY ❑ GMIN.MONTHLY&EACH TIME SYSTEM OPERATED' ___ _____, _ _]All ed for momtonnyofwWned emey .enamor fud ppn�oMy per HSCj_3313(EIf3L C36.SUCTION PIPING MEETS EXEMPTION CRITERIA.123 CCR§263 03)1 +•Xr-s0 ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20.CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM. 41X'-s ❑ 99.OTHER(Specify) J.er4.9)5t L'PCF UST-0(12/2007)-1/4 www.unidocs.org