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l UNDERGROU* STORAGE TANK MOIOORING PLAN For use by Unidocs Member Agencies or where approved by your Local Jurisdiction Authority Cited.- Title 23 CCR,Sections 2632(d)(1), 2634(d)(2), and 2641(h) TYPE OF ACTION ❑ 1.NEW PLAN N 2.CHANGE OF INFORMATION Mol' PLAN TYPE N MONITORING IS IDENTICAL FOR ALL LISTS AT THIS FACILITY. Mot. (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) - - FACILITY NAME Tower Mart#104 M03. FACILITY SITE ADDRESS 192 Lathrop Rd mon. CRY Lathrop, CA Mos. II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE State law requires that testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)be performed in Moo. accordance with the equipment manufacturers'instructions,or annually,whichever is more frequent Such work must be performed by qualified personnel. MONITORING EQUIPMENT IS SERVICED N I.ANNUALLY El 99.OTHER(Specify): M07. III. MONITORING LOCATIONS This monitoring plan must include a Site Plan showing the general tank and piping layouts and the locations where monitoring is perfumed(i.e.,location of each sensor, line leak detector,monitoring system control panel,etc.). If you already have a diagram(e.g.,current OST Monitoring Site Plan from a Monitoring System Certification form Hazardous Materials Business Plan map,etc.)which shows all required information include it with this plan. IV. TANK MONITORING MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S):(Check all that apply) Mill. ® L CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) SECONDARY CONTAINMENT IS: N a.DRY ❑ b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM MLI' PANEL MANUFACTURER: Veeder-Root M12. MODEL#: TL350 _ MIs' LEAK SENSOR MANUFACTURER: Veeder-Root M14. MODEL#(S): 0794390-420 M15. ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL T NK(S) PANEL MANUFACTURER: M16. MODEL#: Mn. IN-TANK PROBE MANUFACTURER: MIS' MODEL#(S): MIS. LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILYNIGHTLY ❑ c.WEEKLY nao. ❑ d.MONTHLY ❑ e.OTHER(Specify): M21. PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): M22. M23. ❑ 3.INVENTORY RECONCILIATION ❑ a.MANUAL PER 23 CCR§2646 ❑ b.STATISTICAL PER 23 CCR§2646.1 M24. ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)PER 23 CCR§2645 TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS A125' ❑ 5.INTEGRITY TESTING PER 23 CCR§2643.1 TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): MM. M27. ❑ 6.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(gopi.agwcy approval) M2&. ❑ 99.OTHER(Specify): V. PIPE MONITORING MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) wo. ® I.CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(S)/TRENCH(ES)AND OTHER SECONDARY CONTAINMENT SECONDARY CONTAINMENT IS: N a.DRY ❑ b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM PANEL MANUFACTURER:Veeder-Root M32' MODEL#: TL350 M33. LEAK SENSOR MANUFACTURER: Veeder-Root _ M34' MODEL#(S): 794390-420 5' WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN? N a.YES ❑ b.NO M36. WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? N a.YES ❑ b.NO M" ❑ 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 MLLDMANUFACTURER(s): "138 MODEL#(S): S' ❑ 3.ELECTRONIC LINE LEAK DEFECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS ELLD MANUFACTURER: M40' MODEL#: M41. PROGRAMMED LINE INTEGRITY TESTS: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. M42. WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M41- WILL ELLD FAILURE/DISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M44 ❑ 4.INTEGRITY TESTING TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) M45. M46. ❑ 5.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY- ❑ c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED" M47. •Reu"nn agcocy approval •v Allowed for monitoring ofuntaaied etrun,=y Bemstor fuel piping only pa HSC§25281.5(b)(3) ❑ 6.PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXEMPTION FROM MONITORING PER 23 CCR§2636(a)(3) ❑ 7.NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) ❑ 99.OTHER(Specify) M48. UN-022A-1/5 www.unidocs.org Rev.10/14/03