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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUNDSTORAGETANK MONITORING PLAN- Pae l of 2) TYPE OF ACTION ❑ I.NEW PLAN ❑ 2.CHANGE OF INFORMATION 090.1 PLAN TYPE ❑ 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 49°-2 (Check one item only) ❑ 2.THIS PLAN COVERS ONLY T14E FOLLOWING UST SYSTEM(q)- L FACILITY INFORMATION FACILITY ID 4(Agency Use Only) BUSINESS NAME(Same as FACILITY NAME) +S '��3/ (, PLAZA 3. BUSINESS SITE ADDRESS 1560c AELAAI FDhO 103' CITY IL 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 frequent,and that such work must be performed by qualified personnel. 23 CCR§2632,2634,2638,2641) MONITORING EQUIPMENT IS SERVICED tj4j.ANNUALLY ❑ 99.OTHER(Specify): 4903b III.MONITORING LOCATIONS 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. Lj 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMTTTED. (23 CCR§2632, 2634)49W IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 49°-5 VAULT(S)WITH AUDIBLE AND VISUAL AJ,ARMS. (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: _['a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED _❑d.UNDER VACUUM PANEL MANUFACTURER._ T1 LEAK SENSOR MANUFACTURER: rEvD - � ----^^90-9. MODEL#(S): 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 490-11 PANEL MANUFACTURER_ 49°.12. 490.13 MODEL#: IN-TANK PROBE MANUFACTURER: _ 690'16' MODEL#(S): 49015 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ a WEEKLY 49°-16 ------!_- d.MONTHLY___._____._____.___0 e_OTHER(Spec_fy) 490.17 PROGRAMMED TESTS: ❑ a.0.1 g.pA ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): 49°19 490.19 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490.20 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 49021 490.22 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 49023 TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 090-20 490-5 [:199.OTHER (Specify): 69x26 490-27 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) CONTINUOUS MONITORING OF PIP PD?ING SUMPS)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 49028 VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT 1S: a.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM - 49029 PANEL MANUFACTURER: -r;:EUFi -- K-O(JT MODEL#: 490-31 LEAK SENSOR_MANUFACTURER:_ EE D_E_1L-, _O-o�_ _ __ °9032 _-MODEL#_(S).� ,L_ _ 6x''33 PIP G LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. PJ�a.YES El b.NO °90-36 AILUR&DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. -a.YES ❑b.NO 49045 L\V2.MECHANICAL LINE LEAK DETECTOR(1NLLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DE EC C3 --_ _j_ ____ __" _ 49.36 MLLD MANUFACTURER(S): _ ❑ 3.ELECTRONIC LINE LEAK DETECTOR(E>..LDj TjaT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 49039 ELLD MANUFACTURE) 690-0° MODEL#S_._._____ 49041 PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO °9043 ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO °90-06 4.PIPE INTEGRITY TESTING°seas TEST FREQUENCY E] a.ANNUALLY ❑ b.EVERY 3 YEARS El c.OTHERS i 49046 49°47 5.VISUAL PIPE MONFFORING' 49°48 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED- 49049 Allowed rm momtonn,orwbmiad - enamor awl-i-i--o HSC 25281561 ❑ 6.SUCTION PIPING MEETS EXEMPTIONCR TERIA 123 CCR§2636(1)(3)]. 49050 7.NO REGULAT ago-s1 ED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM ❑ 99.OTHER(Specify) 49052 09°53 UPCF UST-D(122007)114