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Abi AL SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT UNDERGROUND STORAGE TANK MONITORING PLAN - PAGE 1 TYPE OF ACTION ❑ I. NEW PLAN [12. CHANGE OF INFORMATION Mol. PLAN TYPE ❑ MONITORING IS IDENTICAL FOR ALL USTS AT THIS FACILITY. MM. (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION FACILITY ID # (Agency Use Only) _ FACILITY NAME M03. FACILITY SITE ADDRESS M04_ CITY Mos. H. 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.) he performed in MG& accordance with the equipment manufacturers' instructions, or annually, whichever is more frequent. Such work most be performed by qualified personnel. MONITORING EQUIPMENT IS SERVICED ❑ 1. ANNUALLY ❑ 99. OTHER (Specify): MOr. M. MONITORING LOCATIONS This monitoring plan most 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 ploo. IV. TANK MONITORING MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): (Check all that apply) Min. ❑ 1. CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR (INTERSTITIAL) SPACE(S) OR SECONDARY CONTAINMENT VAULTS) SECONDARY CONTAINMENT IS: ❑ a. DRY ❑ b. LIQUID FILLED ❑ c. UNDER PRESSURE ❑ d. UNDER VACUUM Ml 1. PANEL MANUFACTURER: M12 MODEL#: Mu, LEAK SENSOR MANUFACTURER: M14. MODEL#(S): M15. ❑ 2. AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SINGLE WALL TANKISI PANEL MANUFACTURER: Mi6. MODEL #: My. IN -TANK PROBE MANUFACTURER: M's . MODEL #(S): M19. LEAK TEST FREQUENCY: ❑ a. CONTINUOUS ❑ b. DAILY/NIGHTLY ❑ c. WEEKLY Mm. ❑ d. MONTHLY ❑ e. OTHER (Specify): Mat. PROGRAMMED TESTS: ❑ a. 0.1 g.p.h. ❑ b. 0.2 g.p.h. ❑ c. OTHER (Specify): Mu. Mv. ❑ 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 M24. ❑ 5. INTEGRITY TESTING PER 23 CCR §2643.1 TEST FREQUENCY: ❑ a. ANNUALLY ❑ b. BIENNIALLY ❑ c. OTHER (Specify): MW Mgr. ❑ 6.VISUAL MONITORING DONE: ❑ a. DAILY ❑ b. WEEKLY(RNui .eannyve-mnl) ❑ 99. OTHER (Specify): Mg. V. PIPE MONITORING MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) M30. ❑ 1. CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(SYFRENCH(ES) AND OTHER SECONDARY CONTAINMENT SECONDARY CONTAINMENT IS: ❑ a. DRY ❑ b. LIQUID FILLED ❑ c. UNDER PRESSURE ❑ d. UNDER VACUUM Mil PANELMANUFACTURER: M33. MODEL #: M33. LEAK SENSOR MANUFACTURER M34 MODEL #(S): Mas. WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP (i.e., TURBINE) SHUTDOWN? ❑ a. YES ❑ b. NO mm WILL FAILUREMISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a. YES ❑ b. NO Mat. ❑ 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 MLLD MANUFACIURER(s): M38. MODEL #(S): W9. ❑ 3. ELECTRONIC LINE LEAK DETECTOR (ELLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS ELLD MANUFACTURER Mon. 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 Mon. WILL ELLD FAILUREIDISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a YES ❑ b. NO M44. ❑ 4. INTEGRITY TESTING TEST FREQUENCY: ❑ a. ANNUALLY ❑ b. EVERY 3 YEARS ❑ c. OTHER (Specify) MO. M46, ❑ 5. VISUAL MONITORING DONE: ❑ a. DAILY ❑ b. WEEKLY" ❑ C. MIN. MONTHLY & EACH TIME SYSTEM OPERATED-* M47. - Regan. egmry eppmval •• Allowed fmmonita.in8 of uibu.iW emargmry gmaator fud pip, only WHSC 435281.5(bN3) ❑ 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) Moe. SJCEHDd (07/03) -1/4 07/23/03