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[I+IED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN- (Page I oft . . TYPE OF ACTION ❑ 1. NEW PLAN ❑ 2. CHANGE OF INFORMATION 4WI PLAN TYPE ❑ 1. MONITORING IS IDENTICAL FOR ALL LISTS AT THIS FACILITY. 4� 2 (Check one item only) ❑ 2. THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM ' I. FACILITY INFORMATION FACILITY ID 6 (Agertcy Use Oily) 1 BUSINESS NAME (Same as FACILITY NAME) T D 3, BUS [NESS SITE ADDRESS 103' CITY e too. U. EQUIP5ffM TESTING AND PREVENTIVE MAINTENANCE Testing, preventive maintenance, and calibration of monitoring equipment (e.g., sensors, probes, line Icak detectors, etc.) must be perforated 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 L ANNUALLY ❑ 99, OTHER (Specify): 490'3' 490-3b III. MONITORING LOCATIONS ❑ 1. NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. El 2. SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR §2632, 2634)4w4 IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): y,pl i.0-,"1i11Uvwaa.ca.anvi�a�,atu.n-rUI(,r.I:UIYVARTUUN"l"AINMENT. VAULT(S) WITH AUDIBLE AND VISUAL ALARMS, (23 CCR §2632.2634) SECONDARY CONTAINMENT IS: a. DRY ❑ c. PRESSURIZER ❑ d. UNDER VACUUM PANEL MANUFACTURER: `tti ri - t0- 490•7' MODEL #: LEAK SENSOR MANUFACTURER: y IV, 490A, MODEL 6(S): EF -2. AUTOMATIC TANK GAUGING (ATG) SYSTEM ED TO MONITOR (23 CCR §2643) PANEL MANUFACTURER: I490-.2. MODEL ft: IN -TANK PROBE MANUFACTURER: LEAK TEST FREQUENCY: ❑ a. CONTINUOUS ❑ d. MONTHLY ❑ b. DAILY/NIGHTLY ❑ c. WEEKLY ❑ c. OTHER (Specify): PROGRAMMED TESTS: ❑ a. 0.1 g p.h. ❑ b. 0.2 g.p.h. ❑ c. OTHER (Specify): ❑ 3. MONTHLY STATISTICAL INVENTORY RECONCILIATION (23 CCR §2646.1): ❑ 4. WEEKLY MANUAL TANK GAUGING (MTG) (23 CCR §2645). TESTING PERIOD: ❑ s 36 HOURS 5. TANK INTEGRITY TESTING (23 CCR §2643.3): TEST FREQUENCY: ❑ a. ANNUALLY ❑ b. BIENNIALLY ❑ c. OTHER (Specify): ❑ b. 60 HOURS ❑ 99. OTHER (Specify): V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Check an that I 1. CONTINUOUS MONITORING OF PIPE/ PIPING SUMP(S) AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND VISUAL ALARMS. (23 CCR §2636) SECONDARY CONTAINMENT IS: Cda, DRY ❑b. LIQUID FILLED ❑c. PRESSURIZED ❑d. UNDER VACUUM PANEL MANUFACTURER 490.30 MODEL N: - A LEAK SENSOR MANUFACTURER: /( !( 490-52 MODEL V(5 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP (i.e., TURBINE) SHUTDOWN. 04. YES ❑ b. NO FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. Va.YES ❑ b. NO 2. MECHANICAL LINE LEAK DETECTOR IMLLD) THAT ROUTINELY PERFORMS 3.0 g.p h. LEAK TFSTS AND RESTRICTS C PRODUCT FLOW WHEN A LEAK IS DETECTED 23 CCR §2§M MLLD MANUFACTURER(S): - _ 490 3r MODEL #(S): -V52 -0C 3. ELECTRONIC LINE LEAK DETECTOR (ELLD) THAT ROUTINELY PERFORMS 3,0 g p h. LEAK TESTS (23 CCR §2636) ELLD MANUFACTURER(S) 49040. MODEL k(S): } 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. 110. YFS ❑ b. NO ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a. YES ❑ b. NO 4, PIPE INTEGRITY TESTING 490.15 TEST FRE UENCY 0 a. ANNUALLY b. EVERY 3 YEARS 0 c. OTHERS if 5, VISUAL PIPE. MONITORING. FREQUENCY ❑ a. DAILY ❑ b. WEEKLY ❑ C. MIA(. MONTHLY & EACH TIME SYSTEM OPERATED' -- Altowed far mmdto t of unburied emer oxyienerm fuel DiPinOardy Pn HSC_W21135(b)(3) ] 6. SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR §2636(a)(3)j. 7. NO REGULATED PIPING PER HEALTH AND SAFETY CODE, DIVISION 20, CHAPTER 6.7 IS CONNECTED TO THE TANKS i ❑ 99. OTHER (Specify) UPCF UST -D (1 28007) 1/4 490.3 49" i9" 49610 490-11 490.13 490-13 490.16 490-13 490.11 490•.9 490.20 490-21 490-72 490.23 490-24 490.23 490-29 490.31 490-33 490-34 490.33 490.36 0. t 2n 4-39 L/ 49043 490.14 490-41 49049 490-50