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Ini 11FIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN- Ps- TYPE s TYPE OF ACTION 04 1.NEW PLAN ® 2.CHANGE OF INFORMATION 49ay PLAN TYPE 50 I.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. (Check one item ml ) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM( L FACILITY INFORMATION r FACILITY ID M(A > gnrcy Use Only) BUSINESS NAME(Same.FACILITY NAME) A SCh P R C,O A M Q M is 101 CITY ST OUZO BUSINESS SITE ADDRESS \�AgSs S• 1 WPv�I �� 11.EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing,preventive mmnteruncc,and cali6reuon of monitoring equipment(e.g.,xruors,probes,lire kak detectors.etc.)must be Performed a the fmque-y specified by the equipment menufxtraers'imtrucrions,m e Iaumlly,whichever is more frequent,and the such work must be performed by qualified prrwmie 23 CCR 2632 2634 2638 2641 Nay` MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY ❑ 99.OTHER(Specify): ~b 111.MONITORING LOCATIONS 1.NEW SITE PLOT PLANANAP SUBMITTED WITH THIS PLAN. L SITE PLOT PLAN/MM PREVIOUSLY SUBMITTED. 123 CCR 1202, 26.0),w IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): .as 19 I.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S)WITH AUDIBLE AND VISUAL ALARMS (23CCR¢2632,2W) woe SECONDARY CONTAINMENT IS ® a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM woa PANEL MANUFACTURER.V E R o G IW5 C+ .� --Lc waio LEAK SENSOR MANUFACTURER:V � - MODEL NIS). wort 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WAL 12 MODEL M: (23 CCR 12643) wry PANEL MANUFACTURE -R MODEL wauwars IN-TANK PROBE MANUFACTURER: MODEL 6(S): b.DAILYMIGHTLY ❑ c.WEEKLY ~7 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ wo-t� ._....____.... ❑ d:MONTHLY.._._..__ _._ [I c.OTHER(SSped�f9:------_-- -._..W_.a_- lt PROGRAMMED TESTS: ❑ a.0.l g.pk ❑ b.0.2 g.pK ❑ c.OTHER(Specily): 4W19 woae ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR 12616.1): vo-yt ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR 12645). TESTING PERIOD: [I e.36 HOURS ❑ b.60 HOURS 4°a2y wags 5.TANK INTEGRITY TESTING(23 CCR 12643.11: wou TEST FREQUENCY: ® a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): Wass wo-u ❑99.OTHER (Specify): 490'31 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that Bpp�) I.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND VISUAL ALARMS. (23CCR12636) yy SECONDARY CONTAINMENT IS:®a.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM PANEL MANUFACTURER \I4'EDOR R O-T r9a3° MODEL#: \LC -3Sr3 4wst _ LEAK SENSOR MANUFACTURER-VCcE oR RN10-C y MODEL6(S): -32-3 wa» PINa• PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.c.,TURBINE)SHUTDOWN. ® YES ❑b.NO rsau FAILUREIDISCONNF.CTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. 0 e.YES ❑b.NO wa35 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3A gp .LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED CCR 2636 490.16 MLLD MANUFACTURER(S): *W37 MODEL 6(S): wa3a 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 gpli.LEAKTFSTS (23 CCR 126�36) +9as9 ELLD MANUFACTURER(S +90 0 MODEL#(S): wo 49°At PROGRAMMED IN LINE LEAK TEST: ❑ I.MINIMUM MONTHLY 0.2 gp.h. ❑ 2.MINIMUM ANNUAL 0.1 gp.tL 990'43 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC KiMP SHUTDOWN. ®a YES ❑b.NO 99°'91 ELLD FAILUREIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ®&YES ❑b.NO x9099 4. PIPE INTEGRITY TESTING wogs TEST FREgUENCY 0 a.ANNUALLY b.EVERY 3 YEARS c.OTHERS i ww6 wa•4T 5.VISUAL PIPE MONITORING. +90'ea FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C MIN.MONTHLY d EACH TIME SYSTEM OPERATED- 62521113(h)(3) PERAT D`12111. 1 ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR 126Wsx3)1. 490.x 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 21,CHAPTER 6,7 IS CONNECTED TO THE TANK SYSTEM I wasl was: ❑ 99.OTHER(Spealy) wase UPCF UST-D(12(2107)IN Scanned by CarnScanner