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UNDERGROUND STORAGE TANK MONITORING PLAN For use by Unidocs Member Agencies or where approved by your Local Jurisdiction OZ Authority Cited: Title 23 CCR,Sections 2632(d)(1),2634(d)(2),and 2641(h) VP7LAN E OF ACTION 1.NEW PLAN ❑ 2.CHANGE OF INFORMATION Moa. TYPE MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. Moz eck one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): FACILITY ID#(Agency Use Only) FACILITY NAME m L-I- Nto3. FACILITY SITE ADDRESS ^Sv W- fi�f fit M04 CITY �� ; MOS, .. UIPM_ENT TESTING ANDnEVENT requires that testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,p probes,line detectors, State law eteclors etc.)be performed in M06 accordance with the equipment manufacturers'instructions,or annually,whichever is more frequent. Such work must be performed by qualified personnel. MONITORING EQUIPMENT IS SERVICED ANNUALLY ❑ 919.OTHER,(Specify): Mol. Ill. MONITORING LOCATIONS is This monitoring plan must include a Site Pian showing the general tank and piping layouts and the locations where monitoring is performed(i.e.,location of each sensor, line leak detector,monitoring system control panel,etc.). If you already have a diagram(e.g.,current UST Monitoring Site Plan from a Monitoring S}'stem Certification form,Hazardous Materials Business Plan map,etc. which shows all required information include it with this plan. IV.. fiA"N 'MUNIT0PdNG VTORING IS PERFORMED USING THE FOLLOWING METHOD(S)_(Check all that apply) Mia. CONTINUOUS ELECTRONIC MONITORIN�G O TANK LAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONT INMENT VAULT(S) SECONDARY CONTAINMENT IS: [To.DRY b.LIQUID FILLED ❑ c.UNDER PRESSURE PANEL MANUFACTURER: E R, W M12 MODEL#: A 111/S k f IC �%S ID MM LEAK SENSOR MANUFACTURER: IE(S�..1 Mia. MODEL#(S): _ L S --I A Mts- ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK S PANEL MANUFACTURER: Mr6. MODEL#: MIT IN-TANK PROBE MANUFACTURER: Mrd MODEL#(S): M19 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILYMIGHTLY ❑ c.WEEKLY M20 El d.MONTHLY ❑ e.OTHER(Specify): Mel PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g.p.h, ❑ c.OTHER(Specify): M22. M23 ❑ 3.INVENTORY RECONCILIATION ❑ a.MANUAL PER 23 CCA§2646 ❑ b.STATISTICAL PER 23 CCR§2646.1 ta324 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)PER 23 CCR§2645 TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS M25. ❑ 5.INTEGRITY TESTING PER 23 CCR§2643.1 �� TEST FREQUENCY: I-] a.,ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): M26. Mei L7 6.VISUAL MONITORING DONE: Er7a.DAILY ❑ b.WEEKLY(Requires ase gappmva) ❑ 99.OTHER(Specify): M2s. V. PIPEMONITORING MOIL TORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) M3o- l.CONTINUOUS ELECTRONIC MONITORING PIPING MP(S)/TRENCH(ES)AND OTHER SECONDARY CONTAINMENT SECONDARY CONTAINMENT IS: a.DRY04rO b.LIQUID FILLED Elc.UNDER PRESSURE a - M Mai, PANEL MANUFACTURER: E w M32 MODEL C /l`'�'-1 Sf:IC a O M33, LEAK SENSOR MANUFACTURER: _ �� M34. MODEL#(S): _'i M35. WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN? ❑ a.YES ❑ b.NO M36- WILL FAILURF/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO MJ7 ❑ 2.MECHANICAL LINE LEAK DETECTOR (MLLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED MLLD s MANUFACTURER : M3s. ( ) MODEL#(S): M3v. © 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS ELLD MANUFACTURER: Moa. MODEL#: Mat. PROGRAMMED LINE INTEGRITY TESTS: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. M42. WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M43. WILL ELLD FAILUREJDISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M44. 4.INTEGRITY TESTING TEST FREQUENCY: �❑ ANNUALLY b.EVERY 3 YEARS ❑ c.OTHER(Specify) Mas. M46, VISUAL MONITORING DONE: 10 a.DAILY ❑ b.WEEKLY* M47. `Requires agency appmva ••Arlowcd for menitwing of unburied emergency generator fuel piping onh per HSC§252ai.5(bx3) ❑ 6.PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXEMPTION FROM MONITORING PER 23 CCR§2636(ax3) ❑ 7.NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) ❑ 99.OTHER(Specify) nfas, UN-022A-115 www.unidocs.org Rev.10/14/03