BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

RFCEIV UNIMID PROGPAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK A-Ul n 4 2013 MONITORING PLAN-(Page I of 2) TYPE OF ACTION ❑1,NEW PLAN ❑ 2.CHANGE OF INFORMATION 490-1 PLAN TYPE [f1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. HEALTH P1k:PARTMENT (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM I. FACILITY INFO"IATION FACILITY 10#(Agency Use Only) - ) BUSINESS NAME(Same as FACILITY NAME) r)4,N --P r 3. 13USINESS SITE ADDRESS r ct 6- 103 CITY tJ f �j3 I04 1I:EQUIPMENT TESTING AND PREVENTIVE:MAINTENANCE. Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors.probes,line leak detectors,etc)must be perfom3ed at the frequency specified by the equipment manufacturers'instructions,or annually,whichever is more frequent,and that such work must be performed by qualified personnel. 23 CCR 2632 2634 2638 264I MONITORING EQUIPMENT IS SERVICED 1�.ANNUALLY ❑ 99,OTHER(Specify): 49904b XIX.MONITORING LOCATIONS, ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. ❑2.SITE PIAT PLANIMAP PREVIOUSLY SUBMITTED, (23 CCR§2632, 2634)490.4 IV.TANK MONITORING.IS PERFORMED USING.THE FOLLOWING.MXTH0D(S); 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490.5 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: [j a.DRY []b.LIQUID FILLED ❑ c.PRESSURIZED El d.UNDER VACUUM 490 c PANEL MANUFACTURER: .)PeaaY /Coo} 490-7. MODEL#; TO 490-5 LEAK SENSOR MANUFACTURER: I ) )) 49-79. MODEL N(S)- v71g -J O 1 A,56 49110 El2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL_TA1`JM (23 CCR§2643) 490-11 PANEL MANUFACTURER 4p0-12' MODEL#: 49113 IN-TANK PROBE MANUFACTURER: 491-14' MODEL#(S): 49115 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILYNIGHTLY ❑ c,WEEKLY 49116 ❑ d.MONTHLY ❑ e.OTHER(Specify): 49117 PROGRAMMED TESTS: Cl a.6.1 g.p.h. ❑ b.0,2 p,h. ❑ c.OTHER Speci : 49119 g. ( fY) 490-19 ❑ 3-MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646-1)_ 490-20 ❑ '4,WEEKLY MANUAL TANK GAUGING(MIG)(23 CCR§2645). TESTING PERIOD: ❑ a,36 HOURS ❑ b.60 HOURS 490-22 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 TEST FREQUENCY: [3 a ANNUALLY [Ib.BIENNIALLY [I c,OTHER(Speciff): 490-as El99.OTHER(Specify): 490-2e ago-z7 V;PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S).(Check all that apply)_ CONTINUOUS MONITORING OF PIPE/PIPING SUMPS)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-26 VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT 1S:gra.DRY ❑b.LIQUID FILLED ❑c,FRESSURIZED ❑d.UNDER VACUUM 490.29 PANEL MANUFACTURER: t 490.30 MODEL#: T-1- S 490.31 LEAK SENSOR MANUFACTURER / IF I 490 32 MODEL 0(5): fl 490.33 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ❑a.YES ❑b.NO 490 34 FAILURFlD1SCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49135 ❑ 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 23 CCR 4Z630 490.36 MLLD MANUFACTURERS: 490-37 MODEL.#(S): Ft i V KI71 s ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)TI4AT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490-39 ELLD MANUFACTURER(S) T AIN*. MODEL w): 49041 PROGRAMMED IN LINE LEAK TEST. C31.MINIMUM MONTHLY 0.2 S.p.h, [J2.MINIMUM ANNUAL 0.1 g.p.tL 490-42 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. Cl a.YES ❑b.NO 49043 ELLD FAILURF/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN, ❑a.YES ❑b.NO 49144 ❑ 4.PIPE INTEGRITY TESTING 490.45 TEST FRE UENCX 0 a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c,OTHER(Specify) 490.46 49047 ❑ S.VISUAL PIPE MONITORING. 49"5 FREQUENCY ❑ a DAILY ❑ b.WEEKLY ❑c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED' 4909 •Allmod for u"hokft Of unbOed tmeratncY gcnamtDf fuej Piling 012 Per HSC§25291-50-M ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA[23 CCR§2636(a)(3)1. 490,50 El 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490-31 49132 ❑ 99.OTHER(Specify) 490-$3 UPCFUST-D(IV2007)1/4