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UNDERGROU& STORAGE TANK MON*O7;"�V7C For use by Unidocs Member Agencies or where approved by your Local 11Authority Cited: Title 23 CCR, Sections 2632(d)(1), 2634(d)(2), and t_U) TYPE OF ACTION ❑ 1.NEW PLAN ® 2.CHANGE OF INFORMATION Mot PLAN TYPE ® MONITORING IS IDENTICAL FOR ALL USTS AT THIS FACILITY. ` Mo2. (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): IV I I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) FACILITY NAME 7-EIBVB§1#32190 Moa. FACILITY SITE ADDRESS 4943 S. Kingsley Moa- CITY Stockton 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 Mod accordance with the equipment manufacturers'instructions,or annually,whichever is more frequent. Such work must be performed by qualified personnel. MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY ❑ 99.OTHER(Specify): MOT III. MONITORING LOCATIONS This monitoring plan must include a Site Plan showing the general tank and piping layouts and the locations where monitoring is performed(i.e.,location of each sensor, line leak detector,monitoring system control panel,etc.). If you already have a diagram(e.g.,current UST 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) Mlo. ® 1.CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) SECONDARY CONTAINMENT IS: ❑ a.DRY ® b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM MI1. PANEL MANUFACTURER: VeederROOt M12, MODEL#: TLS350 M13. LEAK SENSOR MANUFACTURER: VeeerROOt Mia. MODEL#(S): 794380-302 MI5_ ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANKS) PANEL MANUFACTURER: MI6, MODEL#: MIT IN-TANK PROBE MANUFACTURER: MIR. MODEL#(S): M19. LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ It.DAILY/NIGHTLY ❑ c.WEEKLY M20. ❑ d.MONTHLY ❑ e.OTHER(Specify): M21. PROGRAMMED TESTS: ❑ a.0.1gP h. ❑ b.0.2 g.p.h. E3c.OTHER(Specify): M22. M23. ❑ 3.INVENTORY RECONCILIATION ❑ a.MANUAL PER 23 CCR§2646 ❑ b.STATISTICAL PER 23 CCR§2646.1 1`124 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)PER 23 CCR§2645 TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS M2s. ❑ 5.INTEGRITY TESTING PER 23 CCR§2643.1 TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): M26. M27. ❑ 6.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(Requim agency approval) ❑ 99.OTHER(Specify): Meg. V. PIPE MONITORING MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) M30' ® 1.CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(S)/TRENCH(ES)AND OTHER SECONDARY CONTAINMENT SECONDARY CONTAINMENT IS: ® a.DRY ❑ b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM hul. PANEL MANUFACTURER:VeederROOt M32, MODEL#: TLS350 A133' LEAK SENSOR MANUFACTURER: VeederROOt Mia' MODEL#(S): 794380-208 M35. WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN? ® a.YES ❑ b.NO Mia. WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ® 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): VaDOrleSS MIS. MODEL#(S): PLLD M39. ® 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS ELLD MANUFACTURER: Moo. MODEL#: Mat 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 Mal, WILL ELLD FAILUREIDISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO Moa' ® 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. "Requires agency approval ""Allowed for monitoring ofunbuded emergency generator fuel piping only per HSC§25281.5(6)(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-1/3 www.unidocs.org Rev.10/14/03