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i UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN- Pae 1 oft TYPE OF ACTION ❑1.NEW PLAN Lk2.CHANGE OF INFORMATION 49x1 PLAN TYPE N(,1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 69-2 (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S.� FACILITY ID#(Agency Use Only) - BUSINESS NAME(Same as FACILITY NAME) BUSINESS SITE ADDRESS )IAS l.,p kI a AA 1 103- CITY 106. wI esting,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)most be performed at the frequency specified by the equipment manufacturers'instructions,or annually,whichever is more frequent,and that such work most be performed by qualified personnel 23 CCR 826322 2634 --_ -_ MONITORING EQUIPMENT IS SERVICED L ANNUALLY gv0.3a ❑ 99.OTHER(Specify)' 69-3b ❑I.NEW SITE PLOT PLAN/MAP SUBMITTED WITH TATS PLAN. '2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMI'T'TED. (23 CCR§2632, 2630490-4 _ , - - WHS IN . j RE I.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERS'I'1TIAL)SPACE(S)OR SECONDARY CONTAINMENT 490-5 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: ® a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 49M PANEL MANUFACTURER la';16a.-6p CML. 490'7. MODEL#: Z0104opo 490-8 LEAK SENSOR MANUFACTURER: etsltr jjgp x90'9. MODEL#(S): Al ZD 490.10 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONTTORSIN- .P WA .T.TANKISI.(23 CCR§2643) +9017 PANEL MANUFACTURER: a9(6la MODEL#: 49a13 IN-TANK PROBE MANUFACTURER °9P54. MODEL#(S): 490.15 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILYINIGHTLY ❑ c.WEEKLY 490.16 ❑ d.MONTHLY ❑ e.OTHER(Specify); 490-17 PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(S 49-18 (Specify): 490.19 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 49(620 [14,WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: [1 a.36 HOURS E] b.60 HOURS 490.31 49c'm 5.TANK INTEGRITYTESTING(23 CCR§2643.1): gypg3 - TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 490.24 490.25 ❑99,OTHER (Specify): 490-26 ..__. 490-27 MoiW ®1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 49029 VISUAL ALARMS. (23CCR§2636) SECONDARY CONTAINMENT IS:[]s.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d UNDER VACUUM 490-N PANEL MANUFACTURER: G•;1hnru f 690'30 MOD '[(pZ0 L>7Ggo 490.31 LEAK SENSOR MANUFACTURER: ,� .!, 090'32 MODEL O(S): 490-33 - PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ®a YES ❑It.NO 490.34 FAB.URE/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 PRODUCT FLOW WHEN A LEAK IS DETECTED 23 CCR 2636 490.36 MLLD MANUFACTURER(S): y M-1 490.37 MODEL#(S): 1,U 'ZOpe 490.38 ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 49039 ELLD MANUFACTURER(S) 49040 1MODEL41SV 490'41 PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MFNIM UM ANNUAL 0.1 g.p.h. 49015 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a YES ❑b.NO 490'41 ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. Cl a YES ❑b.NO 490x4 4.PIPE INTEGRITY TESTING 49 s TEST FRH UENCY ❑ e.ANNUALLY b.EVERY 3 YEARS Q c.OTHER(5 eci ) 49-4649049 ❑ 5.VISUAL PIPE MONITORING. 69046 FREQUENCY ❑ e.DAll.Y ❑ b.WEEKLY ❑c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED' 49049 'Allowed farnwvnt.A. 9fwbuned0 'Iuc a mrfed n ad aI 52813 ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(aX3)(. 49050 E] ER 7.NO REGULATED PIPING PHEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.715 CONNECTED TO THE TANK SYSTEM 490.51 ❑ 99.OTHER(Specify) 49(652 490.53 UPCF UST-D(122007)1/4