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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MAR 1 MONITORING PLAN- Page 1 of 2) TYPE OF ACTION ❑1.NEW PLAN ❑ 2.CHANGE OF INFORMATION Sq dY0.1 PLAN TYPE ❑ 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. H�ENVIgpNh�ENOTUIV TY 2 (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM( L FACILITY INFORMATION NT FACILITY ID#(Agency Use Only) BUSINESS NAME(Same as FACILITY NAME) 0 3S �RA�`LL Pt+zA 3 BUSINESS SITE ADDRESS 1J 00 OLAN Ktpn 103' CITY LATHRA la 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 equipment manufacturers'instructions,or annually,whichever is more frequent,and that such work must be performed by qualified personnel. 23 CCR 2632 2634,2638,264 1) _ MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY ❑ 99.OTHER(Specify): 4990-in III.MONITORING LOCATIONS El 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 2634)49-4 IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S):Er 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490.5 VAULT(S)WITH AUDIBLE AND VISUAL VARMS (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: L'1 a.DRY ❑ b.LIQUID FILLED El c. -__ ---PR_ES4S_9U0.9R-IZED_ ❑d.UN-DE-R_�VACUUM 5 ------------ a49� ° r PANEL MANUFACTURER_ MODEL# ------- --- o-e MODLEAKSINSORMANUFACTU�R 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S),(23 CCR§2643) PANEL MANUFACTURER 49-12. _ MODEL#: _ IN-TANK PROBE MANUFACTURER: -- -__ami°. MODEL#(S): LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY °90-16 _-_-- -_.-_ _ __ ❑ d.MONTHLY _ -__-_❑ e.OTHER(S- ._--__---._---_49-17 -- - - --- - - 49-18 PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): 49-19 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 4Y0.20 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 490.21 490.22 ElS.TANK INTEGRITY TESTING(23 CCR§2643.1): 49-24 TEST FREQUENCY: E] a.ANNUALLY [Ib.BIENNIALLY ❑ c.OTHER(Specify): 4990-zs 490.26 ❑99.OTHER (Specify): 49-27 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) 1.CONTINUOUS MONITORWG OF/DRY PIP PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND a9u-zs VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS: a.DRYY-❑bb..LIQUID FILLED []c.PRESSURIZED ❑d._UND_E_R VACUUM 5 49°-39 _PANEL MANUFACTURER: �l;�F+ M'�I _� _�- a30�-MODEL#- TLS aw31 _ _ _- - °94 : ❑b.N_O__ _ 4-33 #(LEAK SENSOR MANUFACTURER: EEDER_ V S)f�_ - 490"3 PIP G LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN . a_YES AILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. 1A 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 PRODUCT FLOW WHEN A LEAK IS DE ECTED 23 CCR$2636 _-______..--__ __ _-----_--_-- 49-36 �_ �_-___-- 490.37 Boo 49-38 MLLD MANUFACTURER(S): I MODEL#(S): ❑ 3.ELECTRONIC LINE LEAK DETECTOR(Et.LU)`fHaT ROUTINELY PERFORMS 3.0 g.p.b.LEAK TESTS (23 CCR§2636) __ 490-39 -- .--_ - _ MO ELLD MANUFACTURER(S) -__DEL# -'490-1 _ __ PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2gP h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490'43 ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490.44 ❑ 4.PIPE INTEGRITY TESTING 49045 TEST FREQUENCY ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHERS i 490.4649047 ❑ 5.VISUAL PIPE MONITORING. 49-4s FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED' 49-49 'Allowed for mmlronn of mwne emm mw enemor fuel i in only r HSC 25281.5b 3 ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(a)(3)). 490-s0 ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.715 CONNECTED TO THE TANK SYSTEM 490-51 a9o-sz ❑ 99.OTHER(Specify) a9-s3 UPCF UST-D(12/2007)1/4