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SEF'-10-2009 17:00 CITY OF LODI 209 333 6710 P.05
<br /> UNDERGROUi ._ STORAGE TANK MONI _ JRING PLAN
<br /> For use by Unidoes Member Agencies or where approved by your Local Jurisdiction
<br /> Authority Cited: Title 23 CCR, Sections 2632(d)(1), 2634(d)(2), and 2641(h)
<br /> TYPE OF ACTION ❑ L NEW PIAN ® 2.CHANGE OF INFORMATION (
<br /> PLAN TYPE ® MONITORING IS IDENTICAL FOR ALL UST,,AT THIS FACILITY, X02'
<br /> (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S);
<br /> I. FACILITY INFORMATION
<br /> PACIL17Y ID#(Agency Use Only) - -
<br /> FACILITY NAME City of Lodi, Municipal Service Center Moa.
<br /> FACILITY SITEADDRHSS 1331 S. Ham Lane M01 CITY Lodi, CA_ 95242 tiros
<br /> H. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE
<br /> State law requires that testing,preventive maintenance,and calibration of monitoring equipment(c,g.,sensors,probes,line leak detectors,ctc.)be performed in M06.
<br /> accordance with the equipmont manufacturers' instructions,or annually,whichever is more frequent. Such work must be performed by qualified personnel.
<br /> M°7
<br /> MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY ❑ 99.OTHER(Specify):
<br /> 111. MONITORING LOCATIONS
<br /> This monitoring plan must include a Site Plan showing the general tank and piping layouts and the locations where monitoring is performed(i.e.,location of each sensor,
<br /> lino leak detector,monitoring system control panel,ctc.). If you already have a diagram(c.g.,current UST Monitoring Site Plan from a Monitoring System Certification
<br /> form,Hazardous Materials Business Plan map,etc,)which shows all required information_include it with this plan.
<br /> IV. TANK MONITORING
<br /> M10
<br /> MONITORING IS PE=RFORMED USING THE FOLLOWING METHOD(S):(Check all that apply)
<br /> ® 1.CONTINUOUS ELEC]'RONIC MONITORING OF TANK ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S)
<br /> SECONDARY CONTAINMENT IS; ® a.DRY ❑ b,LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM M"
<br /> M1z.
<br /> PANEL MANUFACTURER; Veeder-Root MODEL 4: TLS 350 M13.
<br /> LEAK SENSOR MANUFACTURER: Veeder-ROnt Ml° MODEL#(S); 420 Mss,
<br /> ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TAN '5 ht1�,
<br /> PANEL MANUFACTURER: M16 MODEL#:
<br /> IN-TANK PROBE MANUFACTURER: M1e MODEL#(S): M19
<br /> LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY M20.
<br /> ❑ d,MONTIILY ❑ c.OTHER(Specify): Twat.
<br /> Mz2 M23.
<br /> PROGRAMMED TESTS: ❑ a,0,1 g•P•h. E] b.0.2 g.p.h. Elc.OTHER(Specify)'
<br /> M2A.
<br /> ❑ 3,INVENTORY RECONCILIATION ❑ a.MANUAL PER 23 CCR§2646 ❑ b.STATISTICAL PER 23 CCR§2646,1
<br /> ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)PER 23 CCR§2645
<br /> TESTING PERIOD: ❑ a.36 HOURS ❑
<br /> b.60 HOURS M25.
<br /> ❑ S.INTEGRITY TESTING PER 23 CCR§2643.1
<br /> M26. IHS?.
<br /> TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify):
<br /> ❑ 6-VISUAL MONITORING DONE; ❑ a.DAILY ❑ b.WEEKLY(Kmlrc9 agency approvnt)
<br /> M28.
<br /> ❑ 99.O'T'HER(Specify).
<br /> V. PIPE MONITORING
<br /> M7°,
<br /> MONITORING IS PERFORMED USING THE FOLLOWING METIIOD(S)(Check all that apply)
<br /> ISI 1.CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(S)iTRENCH(ES)AND OTHER SECONDARY CONTAINMENT
<br /> SECONDARY CONTAINMENT IS: ® a.DRY ❑ b,LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM rk31.
<br /> Veeder_R "' MODEL#: TLS 350
<br /> p,gNF:L MANUFACTURER; OOt __
<br /> M35.
<br /> LEAK SENSOR MANUFACTURER: Veeder-ROOt _ _ M34 MODEL 4(S):
<br /> 208
<br /> WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP(i,c., TURBINE)SHUTDOWN? ® a,YES ❑ b.NO M36.
<br /> WILL FAILURIIDISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? M a,YES ❑ b.NO M37.
<br /> ® 2.MECHANICAL I.INE LEAK DETECTOR (MLLD) THAT ROUTINFI.Y PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF
<br /> PRODUCT FLOW WHEN A LEAK IS DETECTED
<br /> MILD MANUFACTURER(,,);F F a orless Manuf.. InC. NMI) M's' MODEL#(S): STP-MLD-D; 99 000 LD2M'9
<br /> ...-P�IC4.
<br /> ❑ 3.ELECTRONIC LINK LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS
<br /> M41.
<br /> ELLD MANUFACTURER: M40. MODEL#:
<br /> PROGRAMMED LINE INTEGRITY TESTS: ❑ u.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL,0,1 g.p.h. M4z.
<br /> WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO Ma,,
<br /> WILL ELLD FAILURE/DISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M44
<br /> ❑ 4.INTEGRITY TESTING
<br /> M45. M46
<br /> TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS [] c.OTHER(Specify)
<br /> ❑ S.VISUAL MONITORING DUNE: ❑ a,DAILY .R�Iro arteacyE ppronl .aWowc pr anon orriing c Oc9ux�Y�6�y 8 naMa N p pEe 004'P�ES�4 szsi.s(b)(s)
<br /> ❑ 6.PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXL•MPTION FROM MONITORING PER 23 CCR§2636(a)(3)
<br /> ❑ 7.NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s)
<br /> M49,
<br /> ❑ 99.OTHER(Specify)
<br /> UN-022A-115 www.unidota.org Rev.10/14/03
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