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IED PROGRAM CONSOLIDATED FO UNDERGROUND STORAGE TANK MONITORING PLAN- Pae 1 of 2 TYPE UFAC I ION ❑ 1.NEW PLAN N 2.CHANGE OF INF'ORMA'TION 4'10 1' PLAN TYPE 0 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): L FACILITY INFORMATION FACILITY ID#(Agency Use Only) 1. BUSINESS NAME(Smne as Facility Name or DBA) 3. My Mini Mart BUSINESS SITE ADDRESS 1756 Wilson Way tag CITY Stockton 104. H. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)most be performed at the frequency specified b the a ant manufacturers'instructions,o_r annu_ate,whichever is,more frequent.Such work must he Derformed b�qualified personnel.[23 cCR§2612,2690.z6sR 11-1-11 MUNIIOIUNG EQUIPMEN I IS SERVICED ❑ I.ANNUALLY ❑ 99.UI HER(Specify): 491.3. 490.36. M. MONITORING LOCATIONS ® 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN ❑ 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED [23 cert§1632,1694] 4904' FV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S; = 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) 490-5- WITH 90-6WITH AUDIBLE AND VISUAL ALARMS.[23 CCR§2632,26341 SECONDARY CONTAINMENT IS: 0 a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 460'6. PANEL MANUFACTURER: Incon 49 7. MODEL#: TS-1001 490-8. LEAK 6FN6QRiviiivuTACTtixER: TSP A00'0- MODEL#(S): STD-101, EIS 19ara 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).In CCR§2643] ago-it. PANEL MANUFACTURER: 490-12. MODEL#: 49 13. IN-TANK PROBE MANUFACTURER: 490'14' MODEL#(S): 4W15. LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490'16. ❑ d.MONTHLY ❑ e.OTHER(Specify): 490"17. PROGRAMMED TESTS:_ 11a.0.1 g.p.h. [Ib.0.2 g.p.h. 11c.OTHER(Specify): 4�119,)e' ❑ 3._MONTHLY STATISTICAL INVENTORY RECONCILIATION[23 cert§26a6.t1 4x1-20. ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)[n cca§261-51 TESTING PERIOD: ❑ a.36 HOURS [Ib.60 HOURS 4W23. _. .--._..__._ 490-21 ❑ 5.TANK INTEGRITY TESTING PER[n cert 92W.11 494-23. TEST FREQUENCY: ® a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify) 491-24. P�I37 491-25. ® 99.OTHER(Specify): Visual Monitoring Daily 49P27X V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) "hec" that apply) ® 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 49o-n. [§3"cc6R SECONDARY CONTAINMENT IS: 0 a.DRY E] b.LIQUID FILLED 1-1c.PRESSURIZED [Id.UNDER VACUUM 490.M. PANEL MANUFACTURER:Incon 490'30' MODEL#: TS-1001 4W31. LEAK SENSOR MANUFACTURER: 132' MODEL#(S): ULS 490-33. PIPING LEAK ALARM'1'RIQGERS AUI'OMAI'IC PUMP(i.e.,'I URBINE)SHUTDOWN. 0 a. YES ❑ b.NO 490-34. FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑ b.NO 490-35. 2..MECHANICAL LINE LEAK DETECTOR(MLID)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF +90-34 PRODUCT FLOW WHEN A LEAK IS DETECTED.In cert§26361 MELD MANUFACTURER(s) Red Jacket 490"37' MODEL#(S): FX-1V iL.0 ZOC)Q 490-38. ------ ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINIELY PERFORMS 3.0 g.p.h.LEAK TESTS.[23 CCR§2636] Oxo-39. ELLD MANUFACTURER(S): 41' MODEL#(S): 490x1. PROGRAMMED IN LIME LEAK TEST: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. 49042. ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 49043. ELLD FAILUREiD1SCONNrECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 1901-1 ❑ 4.PIPE INTEGRITY TESTING. 49045. TEST FREQUENCY: ® a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 49 9900-46' ® 5.VISUAL PIPE MONITORING-- --- -_-_ 1-9049. FRFQI TFNCY' ® a DAILY ❑ h WFFKTV ❑ o. MIN MONTHTYRFACHTrmFRYRTF'mnPFRATFD4 491-49- -A&W04 91-49.•A&W04 for T2Wd_ gueimb..d mmg.yR .=a,A.1PipmoftbawxsC§M81.9@ s)�_ ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA.[23 CCR§2636(1X3)] 490'50' ® 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM. 490-31. _._._ _- C] 490-f1.99.OTHER(Specify) 49093. UPCF UST-D(12/2007)-1/4 www.mddO .erg