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J UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN- Pae 1 of 2 TYPF.OF ACTION ❑ I.NEW PLAN X 2.CHANGE OF INFORMATION 4va.1 PLAN TYPE X 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 4v 2 /Check one item aniy) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION FACILITY ID q(.4gerny Lire On7)/ _ _ I BUSINESS NAME(Some as Facility;Vome or DBA) USAITesoro 88150 BUSINESS SITE ADDRESS 13975 E. Highway 88 101 CITY Lockeford Ia II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing,preventive maintenmum mid calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)most be performed a the frequency specified by the equipment manufacturer ins"etions,or annually,whichever is more frequent.Suc_h work most be performed by qualifiedQersonrml.Iv cta gz63z,m>.,zess_.:wi I -_____ _ .__ -_ - _ MONITORING EQUIPMENT IS SERVICED x 1.ANNUALLY ❑ 99.OTHER S ci 490.1` III. MONITORING LOCATIONS ❑ 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN X 2.SITE PLOT PLAN/MAY PREVIOUSLY SUBMITTED R3 CCR 1263;36341 600'+ IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) that "`�wf X L CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT vAULT(S) +vOJ W ITH AUDIBLE AND VISUAL ALARMS.(v Cat§2632,2634) SECONDARY CONTAINMENT IS: X R DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d. UNDER VACUUM 49 PANEL MANUFACTURER: Gilbarco 400.7 MODEL#- EMC a9°' LEAK SENSOR MANUFACTURER: Veeder Root 690'9 MODEL#(S): 794390-420 60°10 rr 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINQLE WALL TANKlcJ.fv cca pz6OI [vo:i i PANEL MANUFACTURER: 4valz. MODEL#: 690 13 IN-TANK PROBE MANUFACTURER: 6°0'1i MODEL#(S): 490.11 1 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ K DAILY/NIGHTLY ❑ c.WEEKLY +9p'16 ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-13 _-PROGRAMMED TESTS_ ❑ a0.lg_p_h_ ❑ b.0.2 h. ❑ c.OTHERS wale ❑ 1.MONTHLY STATISTICAL INVENTORY RECONCILIATION Iv CCR}.646 it av0.zo _.__ __. _-.. _ __ 4 WEEKLY MANUAL TANK GAUGING(INTO)In ccR 4w4sl TESTING PERIOD ❑ a.36 HOURS ❑ b.60 HOURS 990.31 - .__-.- avo-v. 5. AN fMEGRfTY TESTING PER[v CCR yzbn.11 46ov TEST FREQUENCY: ❑ a ANNUALLY - ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 490.90'34 - _ 's__.- X 99.OTHER(Specify): Tanks are monitored b Sacrificial Anodes. Evan. V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) X I.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CO Iv CCR NTAINMENT WITH AUDIBLE&VISUAL ALARMS. d°028 SECONDARY CONTAINMENT IS: X a DRY ❑ d.UNDER VACUUM g26n1 ❑ b.LIQUID FILLED ❑ c.PRESSURIZED 49429 PANEL MANUFACTURER:Gilbarco 400.30. MODEL#: EMC 49411 LEAK SENSOR MANUFACTURER: Veeder Root i90'12 MODEL#(S): 794380-208 69 13 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. X a YES ❑ b.NO 490-4 FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. X a YES ❑ b.NO 'w-1: X 2. MECHANICAL LLNE LEAK DETECTOR(MELD)THAT ROUTINELY PERFORMS J.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF +9436. PRODUCT FLOW WHEN A LEAK IS DETECTED.Iv CCRJ26361 MLLD MANUFACTURER(S):Vaporless40037 MODEL#(S): LD2000 4s 33. ❑ 3.ELECTRONIC LME LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS[v ccRgzbJbl as0.1v ELLD MANUFACTURER(S): 690'0 MODEL#(S): PROGRAMMED IN LINE LEAK TEST: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. 490.ip ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a YES ❑ b.NO 490-13 ELLD FAILUREIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a YES ❑ b.NO 490.46 S-PIPE INTEGRITY TESTING. - - - - _-- - -- - avori TEST FREQUENCY ❑ a ANNUALLY_ ❑ b.EVERY 3 YEARS ❑ c.O"IHER(S cify) 69049°!'46 Ej 5.VISUAL PIPE MONITORING. - -oaa. FREQUENCY: ❑ eDAILY ❑ b.WEEKLY ❑ C.MIN.MONTHLY&.EACH TIME SYSTEM OPERATED' ._ -.. PIP ❑ 6 SUCTIONONPIPING MEETS EXEMPTION CRITERIA.(n CCR q263q.µ1)I 4vo.16. [I 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM. 99.OTHER(Specify) - - - -� 6vasi i90.5J 11PCF UST-D(122007)-1/S www.unidoes.org