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IED PROGRAM CONSOLIDATED FO UNDERGROUND STORAGE TANK MONITORING PLAN- (Page 1 of 2 TYPE OF ACTION ❑ 1.NEW PLAN ® 2.CHANGE OF INFORMATION 490-1. LAN TYPE ® 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490-2. (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) BUSINESS NAME(Same as Facility Nmne or DBA) 3. My Mini Mart BUSINESS SITE ADDRESS 1756 Wilson Way 103. CITY Stockton too. II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing,preventive muintenance,and calibration of monitoring equipment(e.g.,seasors,probes,line leak detectors,etc.)must be performed at the frequency specified by the equipment manufacturers'instmetions,or annually,whi _.ever is more frequent Such work must be perfonnedby cLmfi�sanneI [BOM§2632,2634 2x34 25411 MONITORING EQUIPMENT IS SERVICED 0 (.ANNUALLY ❑ 99.OTHERS fy): 490'3a ( �i. 490317. III. MONITORING LOCATIONS ® 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH TIES PLAN ❑ 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED [23 cm§2632,2634] 491`4. IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) thCahe" 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) 490-5. WITH AUDIBLE AND VISUAL ALARMS.[23 CCR§M32,2634] SECONDARY CONTAINMENT IS: ® a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 490 . PANEL MANUFACTURER: IDCOn 490'7' MODEL#: TS-1001 490'1. LEAK SENSORMANUFACTURER: TSP 491`9. MODEL#(S): STD-101, EIS 491`10. -0-2 AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANKfSL[23 CCR§26431 491`11. PANEL MANUFACTURER: 49012. MODEL#: 49043. IN-TANK PROBE MANUFACTURER: 490-14. MODEL#(S): 491`15. LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c,WEEKLY 490'16. ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17. PROGRAMMED TESTS: _❑ e.0.1 g.p.h_- ❑ b.0.2 g.p.h. -_ ❑ c.OTHER iq� 49011. S c < fy)_ 490-19 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION[23 cm§2646.1] 49020. ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)123 cca§26°51 TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS °90'2 49411. ❑ 5.TANK INTEGRITY TESTING PER[23,cR§1644.11 49023. TEST FREQUENCY: /pANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(S 490-24. ---- _.. - ----(Specify): 491`25. 99.OTHER(Specify): Visual Monitoring Daily 491`%. 49027. V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) r(check-" ® 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 49011. SECONDARY CONTAINMENT IS: ® a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 490-29. PANEL MANUFACTURER:Incon 491`30. MODEL#: TS-1001 490-31. LEAK SENSOR MANUFACTURER: 49032' MODEL#(S): U LS 49033. PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ® e.YES ❑ b.NO 490-34_ FAILURE/DISCONNECTION OF THE MONITORING SYSTEM GGERS AUTOMATIC PUMP SHUTDOWN. ® e.YES ❑ b.NO 491`35. -- - -_ 2.MECHANICAL LINE LEAK DETECTOR(MI.LD)THAT RO PERFOfjMS 3.0$.ph LEAK TESTS AND RESTRICTS OR SHUTS OFF 4�M. PRODUCT FLOW WHEN A LEAK I 3 c 2a4 c(y 'y{p "li _MLLD MANUFACTURER(S): -�_ 9037. MODEL#(S): FX-1 V 9q 1-D 2�b 490-31. ❑ 3.ELECTROMC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.[23 ccR§2636] 490"39. ELLD MANUFACTURER(S): 69041, MODEL#(S): 49041. PROGRAMMED IN LINE LEAK TEST: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MIND"ANNUAL 0.1 g.p.h. 49042. ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 490x3. ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 491`4. ❑ 4.PIPEINTEGRITY TESTING. -- - -- --- ----- i9aas. W.--TEST FREQUENCY: ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 49046. 49247. 5.VISUAL PIPE MONITORING. - FREQUENCY: c DAILY ❑ b.WEEKLY ❑ c.MIN.MONTFII. S�'�'TEM OgE{2ATElY 44 •Aaowe .t rweurie4 omers tw azl¢at. py�y i0-.. 6.SUCTION PIPING MEETS EXEMPTIO�TERIA. 23 CCR§2636(4x3)] 49050. r7.NO REGULATED PIPING PER HEALTH AND SAFETYCODE,DIVISIO 20,CHAP .7 IS CONNECTED TO THE T S S 49x51. ❑ 99.OTHER(Specify) Cj 7f'Q.� - ---�Zls33. 49093. S uNNAI /I 2/M 0y �' SAN JOI.Q:YA COUNTY UPCF UST-D(12/200'1)-U4 J www.vnidocs.org EN'0R0MkIEVTAL HEA'_TH PEPASTkiENT