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BCE#10199-Tanks 1,2,3 NIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN- 1 of 2) TYPE OF ACTION [11.NEW PLAN 19 2.CHANGE OF INFORMATION 490-1 PLAN TYPE ❑ I.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 49"2 (Check one item only) ® 2.THIS PLAN COVERS ONLY THE FOLLOWING USTSYSTEM(S),Tanks 1,2 and 3 I. FACILITY INFORMATION FACILITY ID R(APM7 Use Gdy) 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 BUSINESS NAME(Same as FACILITY NAME)COSTCO GASOLINE(LOC.NO.38) 3. BUSINESS SITE ADDRESS 1616 EAST HAMMER LANE me- I crrY STOCKTON 0 H.EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing,preventive maintenance,and calibration of monitoring equipment(e.g..sensor,probes,line leak detectors,etc.)must be performed at the frequency specified by the equipment manufactuters'instructions,or annually,whichever is more frequent.and that such work must be performed by qualified personnel. CCR 2632,263412638,2641 (2__._.� MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY ❑ 99.OTHER(Specify): 4�3e Ill.MONITORING LOCATIONS ®1.NEN SITE PILOT PLAN/MAP SUBMITTED WITH THIS PLAN. CF2.SITE PLOT PLAN/mAP PREVIOUSLY SUBMITTED. (23 CCR 12632, 26 IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 49"3 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23CCR§2632,2634) SECONDARY CONTAINMENT IS: ❑ a.DRY ® b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM `906 PANBLMANUPACTURER: VEEDER ROOT 40.7- MODEL#: TIS-35OR 490-9 ------------------- ------ - ------------- -MODEL ------- -_._. LEAK SENSOR MANUFACRR2ER: VEEDER ROOT `9"9' MODEL#(S): 794380-301 d90'10 2.AUTOMATIC TANK GAUGING(ATG)SYSTEMI USED TO MONITOR SINGLE WALL TANK($).(23 CCR§2643) 49011 PANEL MANUFACTURER: 49"12 MODEL#: 4WJ3 IN-TANK PROBE MANUFACTURER w0-14. MODBL#(Sk s9a15 LEAKTE.STFREQUENCY. ❑ a.CON77MJOUS ❑ b.DAILYINIGHTLY ❑ -AW16 ❑ d.MONTHLY ❑ e.OTHER(Specify):_.___._.__ -. 49"n --------__._.--_._.--.___-_____ ____. .__.___._.__ 4WU PROORAMMEDTESTS: ❑ a.0.1s.p.h. ❑ b.0.2gp.h. ❑ c.OTHER(Specify): 4W" ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCHdATION(23 CCR 12646.1)t 49um ❑ 4.WEEKLY MANUAL TANK GAUGING(MITG)(23 CCR§2645). TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 49°"22 49023 5.TANK INTEGRITY TESTING(23 CCR 12643.1): 490-21 TEST FREQUENCY: [I A.ANNUALLY [Ib.BIENNIALLY [I c.OTHER(Specify): 4W25 [199.OTHER (Specify}. 49020 4W2t V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) 1.CONTINUOUS MONITORING OF PJPE(PIPING SUMID(S)AND OTHER SECONDARY CONTAINMINNT KITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS:®a.DRY ®b.LIQUID FILLED [1c.PRESSURIZED ❑d.UNDER VACUUM 49x29 -.-..-------_._._._...____-_.-.___.__.____.__-__.__..-..-_-_ gip.____.__.__..._.___..._..._._.._...._.__.-..__ 49031 ppNELMANUPALIVRHR-VEEDERROOT _ MODEL#: TLS-35OR ---•--- --------- --.-----_ -. -... ----..._.--------- - - --- --- -- - 49"32 1 M0DEL#(S): 857080.112;794380-304;_ 490-33 LEAK SENSOR MANUFACTURER: VEEDER ROOT 794380-352(REG T1 FILL) - •-----------------------------------------._.-----------------------------------._-----.__.------.._.-------------- - 49"54 PBING LEAK ALARM TRIGGERS AOTOMfATIC PUMP(i.e.,TURBINE)SHII7DOWN. ®a.YES ❑b.NO FAILUREIDISCONNECfION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ®a YES Ob-NO 49"33 Ll 2.MECHANICAL LINE LEAK DETECTOR((ML D)THAT ROUTINELY PERFORMS 3.0 g p.h.LEAK TESTS AND RESTRICTS ORSHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED123 CCR 2A3490-35 >s ------MLLD MANUFACTURER(S): - 490-31 MODEL#(S): ® 3.ELECTRONIC LINE LEAK DKTECTOR(ELLD)THAT ROUTINELY PERFORM 3.0 g p.h.LEAK TESTS (23 CCR 12636) _ 49"39 - ELLD MANUFACTUMR(S)VEEDER ROOT 490"4°_ MODEL#(S): PLLD PROORAMIMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g p h. ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ®e.YES ❑b.NO 49°03 Fit FAILUREIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ®e.YES ❑b.NO 09°04 4.PIPE INTEGRITY TESTING 4 s TEST FRE UENCY U a.ANNUALLY b.EVBRY 3 YEARS c.OTHERS 490-4649047 5.VISUAL PIPE MONITORING. 49°48 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑c.MCN.MONTHLY do EACH TIME SYSTEM OPERATED' 49W9 •Albxed far nnoaoi o(uaduicd ewer erc <rcmwfuel W o07 HSC 2301 6 ) ❑ 6.SUCTION PIPING M SETS EXEMIPTION CRITERIA 123 CCR§2636(a)(3)]. 49"30 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 49"31 49"32 0 99-OTHER(Specify) 49"33