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f UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN - (Page 1 of 2) TYPE OF ACTION ❑ 1.NEW PLAN ® 2.CHANGE OF INFORMATION 4904. PLAN TYPE ® 1.MONITORNG 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 4(Agency Use Only) _ BUSINESS NAME(Same as Facility Name or DBA) Tower Mali# 886 BUSINESS SITE ADDRESS 1434 W Yosemite Ave. Ire CITY Manteca ,CA 95337 II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing,pmventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must be performed at the frequency specified b ttheueq ipment manufacturers'instructions,or annually,whichever is mom fcequuent_Such work must be perforated byqualified personnel[23 CCR§2632,2634,X13 26411 MONITORING EQUIPMENT IS SERVICED Z 1.ANNUALLY [199.OTHER1 40.34. (SP�fY): 4903b. III. MONITORING LOCATIONS ❑ I.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN Z 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED In CCR§2632,26341 6964" IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) that c" I.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) 490.5. WITH AUDIBLE AND VISUAL ALARMS.(23 CCR§2532.26341 SECONDARY CONTAINMENT IS: N a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 49 ' PANEL MANUFACTURER: Veeder-Root 4902 MODEL#: TLS350 4968. LEAK SENSOR MANUFACTURER: Veeder-Root 69x9" MODEL#(S):794390-420 490-10. -CF2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE W l. T NK( ).[23 CCR§2543] 490.1. PANEL MANUFACTURER: 490.12 MODEL#: 49613. IN-TANK PROBE MANUFACTURER: 49614, MODEL#(S): 490-15. LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/MGHTLY ❑ c.WEEKLY 49616. ❑ d.MONTHLY ❑ e.OTHER(Specify): 40.17. PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): 018. 09 490-19.9. ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION[23 cm§2516.17 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)[23 con§2 51 TESTING PERIOD: ❑ &.36 HOURS ❑ b.60 HOURS 490.22 ❑ 5.TANK INTEGRITY TESTING PER In CCR§2643.11 69623. 490-24. TEST FREQUENCY: ❑ a.ANNUALLY [Ib.BIENNIALLY E] c.OTHER(Specify): 49 25. TW-2y- C3 8.26❑ 99.OTHER(Specify): 4937. V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) i(iakeck' ® 1.CONTINUOUS MONITORING OF PIPE/P§PNG SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 490'28. 123 cCR SECONDARY CONTAINMENT IS: ® a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 090.29' §25361 PANEL MANUFACTURER:Vender-Root °90-30. MODEL#: TLS 350 49031. LEAK SENSOR MANUFACTURER: Veeder-Root °90.32. MODEL# 0794380-208 490.33. PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ® a.YES ❑ b.NO 49634. FAILUREIDISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. R a.YES ❑ b.NO 40.x5. 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF 490.36. PRODUCT FLOW WHEN A LEAK IS DETECTED.In cm§25361 MLLD MANUFACTURER(S):FE Petro-STP-MLD VMI 437. MODEL#(S):Ve orless LD-2000 490'18' ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.In ccR§26361 498.39. ELLD MANUFACTURER(S): 69006- MODEL#(S): 49041. PROGRAMMED IN LINE LEAK TEST: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. 49042 ELLD DE LECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 49043. ELLD FAILUREIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a YES ❑ It.NO 4968.4. ❑ 4.PIPE INTEGRITY TESTING. 49 TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(SpeciTy) 490 77 .a ❑ S.VISUAL PIPE MONITORING. FREQUENCY: ® a.DAILY ❑ b.WEEKLY ❑ C.MEN.MONTHLY&EACH TIME SYSTEM OPERATED' 49049. •Allowed for modrorioX ofuoburie4 emvpencv xmvet9rfiwl vioeaooN M33aC§25261.5 )(3) _ ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA.In cm§2636(5)(3)1 49050. ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.715 CONNECTED TO THE TANK SYSTEM. 49051. 49x51 ❑ 99.OTHER(Specify) 40.63. UPCF UST-D(126007)-1/4 3vww.un§docs.org