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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN Pae 1 of 2 TYPE OF ACTION Q 1.NEW PLAN ❑ 2.CHANGE OF INFORMATION PLAN TYPE Q '1 ONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION FACILITY ID#(Agencv Use Only) 1-- _ 2 J 161 ) B INESS NAME(Same as Facility Name or DBA) P371 Ar r T B'U ESS SITE DRESS CITY © �► II" QUIPMENT 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 Ay _cguip"w"t manufaeturm,m3buctians or annually,whichever is more frequent.Such work must be ©rmed qua_l ti d personnel.Iz3 CCR§2632.2634,263s.264 11 MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY [399.OTHER(Specify): 490 b III. MONITORING LOCATIONS ❑ 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED [23 CCR§2632.26341 axia IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (h heaekau CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) $ WITH AUDIBLE AND VISUAL ALARMS.lz3 ecR§265x,26341 SECONDARY CONTAINMENT IS: 62 a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSUMED ❑ d.UNDER VACUUM 4`°0-6 PANEL MANUFACTURER: 4j 490-7. MODEL#: �]�pS 49(" LEAK SENSOR MANUFACTURER: 490-9. MODEL#(S): j -72 ° 10 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED O MONITOR SINGLE WALL TANK(S).123 CCR§26431 490-11 PANEL MANUFACTURER: 490-12' MODEL#: 490.13 [N-TANK PROBE MANUFACTURER: 490.14. MODEL#(S): 49°-15 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c,WEEKLY 490-16. ❑ d.MONTHLY ❑ e.OTHER(Specify): 49047 PROGRAMMED TESTS: a_0.l h. b.0.2 h. c.OTHERS i 419 _ ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION[23 CCR 42646-11 490 o_ ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)[23 crit§26451 TESTING PERIOD: ❑ &36 HOURS ❑ b.60 HOURS49490 21. o-za ❑ 5,TANK INTEGRITY TESTING PER 123 ceR§2643.11 490-23_ TEST FREQUENCY: [3a.ANNUALLY ❑ b.BIENNIALLY e.OTHER(Speclf): 4902524 49u-26. 99.OTHER(Specify): 490 2V V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Cheekrrli Ghat a Iv CONTINUOUS MONITORING OF PIPE/PI PING UMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 41x28 I23 CcR SECONDARY CONTAINMENT IS: a.DRY [3b.LIQUID FILLED (3c.PRESSURIZED ❑ d.UNDER VACUUM 490'29. §2636] PANEL MANUFACTURER: 49&-3{1. MODEL#: X -146 °90.31. LEAK SENSOR MANUFACTURER: VQ" _ AXJ 49&-32. MODEL#(S): � 490-33. PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. (3a.YES b NO 490-34. FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a_YES &b.No 490-35. 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF 490,14 PRODUCT FLOW WHEN A LEAK IS DETECTED[23 CCR§26361 i1 MLLD MANUFACTURER(S):. F'7'rQ 410-33. MODEL#(S): �-` W 49-A ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.[23cCR§26361 ,19039. ELLD MANUFACTURER(S): ' 490-40. MODEL#(S): 49041 PROGRAMMED IN LINE LEAK TEST: ❑a.MINIMUM MONTHLY 0.2 g.p.h, ❑ b.MINIMUM ANNUAL 0.1 g,p.h. 490142 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 490.43. ELLD FAILUREIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. 13 &YES ❑ b.No 490-44 -Cr4.PIPE INTEGRITY TESTING. 490-43. 046 TEST FREQUENCY: ANNUALLY 13b.EVERY 3 YEARS ❑ c.OTHER(Specify) 49"7. _ ❑ 5.VISUAL PIPE MONITORING. 4eu48, FREQUENCY; ❑ a.DAILY ❑ b.WEEKLY ❑ C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED- 490 45 "n11aa ro<,nweu,nay of ub.c ed .s .xeneruor riyspna only rlsc§zszxl.stnx3t ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA.123 CCR§26Wax31[ 490.50, ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM. 490-5 1. 49052 99.OTHER(Specify) 53. UPCF UST-D(12/2007)-114 www.usidoes.org