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a F_I SJCEHD-d (07/03)- 114 uncarw SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT UNDERGROUND STORAGE TANK MONITORING PLAN - PAGE 1 MOt. TYPE OF ACTION I. NEW PLAN ❑ 2 CHANGE OF INFORMATION Mm PLAN TYPE MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. (Check ane item only) ❑ TRIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION FACILITY ID # (Agency Use Only) "'=d Mm. FAC[LITYNAME 0 M N 5 MOS. ` CITY FACILITY STPE ADDRESS S tZ 4 1l0.) Mw s II, Q NT TESTING AND PREtrJK-NT MA TENANCE Slate -law that testing. Pro%entive maintenance, and calibration or monitoring egwpmeat (e.g., sensors, probes, Ime kali detectors, etc.) be performed in Such be by qualified personnel. Ma: accordance with the equipment manufaetmers' instructions, or annuallyy`ehieheeer a more frequent. work most performed 1107 MONITORING EQUIPMENT IS SERVICED �1. ANNUALLY ❑ 99. OTHER (Specif)): . MC�IiIORTNG LOCA<)�1S This mnmtorma plan must include a Site Plan showing the general tank and piping la)'omt and the locations where monitoring is performed (i.e., location of each seasoy UST Monitoring Site Plan from a Monitoring Systern Certification line Irak detector. monitoring system control panel, etc.). If you already have a diagram (c.e.. current Ian. form. hazardous Materials Business Plan map. etc.) which shows all fired information. include it with this IV. TANKMONITORING MOt TrORING IS PERFORMED USING THE FOLLOWING METHOD(S): (Cbeck all that appty) ❑ 1. CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR (INTERSTITIAL) SPACE(S) OR SECONDARY CONTAINMENT VAULTS) Mlt SECONDARY CONTAINMENT 7 DRx ❑ b. LIQUID FILLED ❑ - (16IDER PRESSURE ❑ d. UNDER VACUUM ,,a/. PANEL MANUFACTURER: � P(' cA I.fkiT Ins MODEL #: "n S 3_5V Mu. Mls. LEAK SENSOR MANUFACTURER: ,r n.Alh1 MODEL #(S): L17 Z.DOO ❑ 2. AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SINGLE WALLTAN➢Ca5) Mtz PANEL MANUFACTURER: MODEL #: M19. MIs. MODEL #(S); IN -TANK PROBE MANUFACTURER: M2o. LEAK TEST FREQUENCY: {y�'`�` CONTINUOUS ❑ b. DAILY/NIGHTLY E] c. WEEKLY ❑ d. MONTHLY ❑ e. OTHER (Spemfy): M21. M22. PROGRAbhM[IED TESTS: a. 0.1 g.p.h. El b. 02h [I¢.p.a OTHER (Specify):❑ MN3 M1° 3. INVENTORY RECONCILIATION ❑ a. MANUAL PER ti CCR §2646 in L. STATISTICAL PER 23 CCR §2646-1 ❑ 4. WEEKLY MANUAL TANK GAUGING (MTG) PER 23 CCR §2645 M 5 TESTING PERIOD: ❑ a. 36 HOURS ❑ b. 60 HOURS ❑ 5. INTEGRITY TESTING PER 23 CCR §2643.1��(�/ ( M26. M21. TEST FREQUENCY: ❑ a. ANNUALLY ❑ b. BIENNIALLY 11c. OTHER (Specify): ❑ 6.VISUAL MONITORING DONE: [Xa.DAILY ❑ b- WEEKLY Ot�mo.amyawwaU Mza. ❑ 99. OTHER (Speeify): MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) j4 L CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(SyTRENCH(ES) AND OTHER SECONDARY CONTAINMENT FHLED ❑ c. UNDER PRESSURE ❑ d. UNDER VACUUM / SECONDARY CONTAINMENT I�Sp: �' a.DRY� ❑ b. LIVACUUMVACUUMM" � '^ - PANEL MANUFACTURER: \t 90'DZ MilMODEL #: ^:7!1 c � zce W1. LEAK SENSOR MANUFACTURER: VPYiWi/ 9061 Mia' MODEL #(S): LpZOou ams. WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUM]a (Le., TURBINE) SHUTDOWN? a. YES ❑ b. NO Mia' WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? �La. YES ❑ b. NO Ma'' 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 DETEC�T�EDs,, 1j �,�, M33' M39 MLLD MANUFACTURER(s): QCs' oAktSS ❑ 3. ELECTRONIC LINE LEAK DETECTOR (ELLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TEST'S ss - .e... _.S Mao. MODEL#: ELLD MANUFACTURER: b•rs�rv.�u-�- M41. M42. PROGRAMMED LINE INTEGRITY TESTS: ❑ a. MINRMIiM MONTHLY 01 gp.h. ❑ b. MINIMUM ANNUAL 0.1 g.p.h. WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? &14- YES ❑ b. NO M43. WILL ELLD FAHLURE/DISCONNECTION TRIGGER AUTOMATIC PUIv1P SHUTDOWN? jka. YES ❑ b. NO Mu. ❑ 4. INTEGRITY TESTING a, Mas. Mab. TEST FREQUENCY: ❑. s. ANNUALLY ❑ b. EVERY 3 YEARS ❑ e. OTHER (Specify) W: ❑ i.VISUAL MONITORING DONE: a. DAILY ❑ b. WEEKLY' ❑ c. MLN. MONTHLY fi EACH TIME SYSTEM OPERATED'" •pegory apmy approval -AOovMf mwiiotirigafmbmiebumd d emnBwTBaenrorihd PPeB e^tY err HSC §2a281.5@x3) Mn. ❑ 6. PIPING IS SUCTION PIPING MEETING ALI, REQUIREMENTS FOR EXEMPTION FROM MONITORING PER 23 CCR §2636(ax3) ❑ 7. NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) Mas. ❑ 99. OTHER (Specify) SJCEHD-d (07/03)- 114 uncarw