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UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN- Pae 1 oft <br /> TYPEOFACTION ❑LNEWPLAN ❑ 2.CHANGE OF INFORMATION Nevi Far-Ms 4943'1 <br /> PLAN TYPE 0 1.MONITORING IS IDENTICAL FOR ALL LISTS AT THIS FACILITY. 49oa <br /> Check one item old 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM <br /> 1. FACILITY INFORMATION <br /> FACILITY ID#(Agency Use Only) I I I - I 1 1 -11 <br /> BUSINESS NAME(Same as FACILITY NAME) D CO irgep CM 61ZNT7ON- NDC.TRE-PLN CA. 1 <br /> BUSINESS SITE ADDRESS �LNoo F. V k Opr inn. CITY L.-U p 1 1aa <br /> H.EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE <br /> Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leek detectors,etc.)must be performed at the frequency <br /> specified by the equipment manufacturers'instructions,or annually,whichever is mom frequent,and that such work must be performed by qualified personnel <br /> 23 CCR 26¢ 32.263 12638.8 2641L_ <br /> MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY ❑ 99.OTHER(Specify): 0903' <br /> 49 b <br /> 111.MONITORING LOCATIONS <br /> ❑1.NEW SITE PLOT PLANIMAP SUBMITTED WITH THIS PLAN. IS 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, <br /> 263 904 <br /> f <br /> IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): <br /> 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490.1 <br /> VAULTS)WITH AUDIBLE AND VISUAL ALARMS (23 CCR§2632,2634) <br /> SECONDARY CONTAINMENT IS: V) a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490° <br /> PANEL MANUFACTURER:PNEU MODEL q: (-G IOOO e9oa <br /> LEAK SENSORMANUFACTURER: 490.9' MODEL#(S): 1.,5(pOO"LD-SN 49x643 <br /> 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S),(23 CCR§2643) 49011 <br /> PANEL MANUFACTURER: 49o-1z MODEL#: 49x13 <br /> IN-TANK PROBE MANUFACTURER: _ - 4�14. M_Offi. <br /> _DN(S�- -.---.- __a9o-is <br /> LEAK TEST FREQUENCY: ❑ &CONTINUOUS [j b.DAEY_GHTLY ❑ c.WEEKLY 4W6 <br /> ❑ d.MONTHLY ❑ a.OTHER(Specify): °90'17 <br /> PROGRAMMED TESTS: ❑ a.0.1 h. ❑ b.0.2 h. ❑ c.OTHER 49 3 <br /> &P� &P� POOih)� 49019 <br /> ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCHdATION(23 CCR§2646.1): 49 20 <br /> ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 4943.21 <br /> 4 22 <br /> 4943W-2343 <br /> 3.TANK INTEGRITY TESTING(23 CCR§2643.1): <br /> TEST FREQUENCY: ❑ &ANNUALLY ❑ b.BIENNIALLY ❑ 0.OTHER(Specify): 490-35 <br /> 99.OTHER(Specify): RAIL- V1 lAAL MOW I P 106 4 x21 <br /> V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check an that apply) <br /> El I.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 49029 j <br /> VISUAL ALARMS. (23CCR§2636) <br /> SECONDARY CONTAINMENT IS:❑a.DRY ❑b.LIQUID FILLED ❑o.PRESSURIZED ❑d.UNDER VACUUM 490'» <br /> PANEL MANUFACTURER: 49a3o 1 MODEL#: 490431LEAK SENSOR MANUFACTURER: 4W32 MODEL MY 49oa3 <br /> ---PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(La.,TURBINE)SHUTDOWN. ❑a.YES ❑b.NO 490'14 <br /> FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 4s 35 <br /> Lj 2.MECHANICAL LINE LEAK DETECTOR(MILD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFE <br /> PRODUCT FLOW WHEN A LEAK iS DETECl'ED 93 CCR j263_q ____ ......_.... 49 36 <br /> MILD MANUFA S: 49 37 MODEL#(S): 49039 <br /> ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 Ep.h.LEAK TESTS (23 CCR§2636) 490d9 <br /> ELLD MANUFACTURERS)_ _ __ +9oro_ MODEL N(SL_` °9°'17 <br /> PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. 49042 i <br /> ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49 13 <br /> ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑e.YES ❑b.NO <br /> 9044 <br /> Lj 4.PIPE INTEGRITY TESTING 49ws <br /> TEST FREQUENCY s.ANNUALLY b.EVERY 3 YEARS c.OTHER(Specify) VI04649 1 <br /> Lj 5.VISUAL PIPE MONITORING. 494311 <br /> FREQUENCY ❑ &DAILY ❑ b.WEEKLY Xc.MIN.MONTHLY&EACH TIME SYSTEM OPERATED- 49049 <br /> •Nbnd avmmiw,m ofmhurieds «airc ruN wJ nH9C 212b1,1 <br /> ® 6.SUCTION PIPING MEETS EXEMPTION CRITERIA(23 CCR§2636(x)(3)). 4W30 <br /> 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CINFFER 6.7 IS CONNECTED TO THE TANK SYSTEM <br /> 49o-sr <br /> ® 99.10TRER(Specify) ISA C. pmr- LIST DFIMA-Mg 49 53 <br /> UPCF UST-D(12/2007)I/4 <br />