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AL _; IED PROGRAM CONSOLIDATED FO UNDERGROUND STORAGE TANK MONITORING PLAN - Pa e I of 2 490.1 TYPE OF ACTION ❑ 1.NEW PLAN ❑ 2.CHANGE OF INFORMATION PLAN TYPE ❑ I.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. (Check one item only) ❑ 2.THIS PLAN covERs ONLY THE FOLLOWING UST FACILITY INFORMATION I. 1. FACILITY ID#(Agency Use Only) - 3. BUSINESS NAME(Same as Facility Name or DBA) §o0-. 1=l4 103. CITY BUSINESS SITE ADDRESS I-0 ab L ti�.t ea► %1'�- r4V'� ENANCE H. EQUIPMENT TESTING AND PREVENTIVE MAI Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,eta)must be performed at the frequency specified _ _ _ ._. ._ .._.._.. ..._ __._.._Y 9 _ __......p .._ .._..( 490-3a b_the ui ment manufacturers'instructions+or annual) whichever is more fr uent Such work must be performed b uahf ed Ci3UtInCI. 23 CCR§Z632,2634,2636, __ _ _ _... _._. _AL _.__ 99.OTHER(Specify): 490-3b. MONITORING EQUIPMENT IS SERVICED L ANNUALLY ❑ III. MONITORING LOCATIONS 490-4. ❑ I.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN 1 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED [23 CCR§2632,26341 all IV. TANK MONITORING I5 PERFORMEDU SING THE FOLLOWING IWEEOTDVAS LT(S)t 0-490-5. 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTE ) 490.6. WITH AUDIBLE AND VISUAL ALARMS.[23 CCR§2632,26341 Ry ❑ b.LIQUID FILLED ❑ C.PRESSURIZED d.UNDER VACUUM SECONDARY CONTAINMENT IS: ® a.D ❑490.7• 490.3 MO TLS 3 671D490-10. PANEL MANUFACTURER: '14A cbL e- A n RT, 490-9• MODEL#(S _ LEAK SENSOR MANUFACTURER: ._------.-.........___-._._ 490-11. 490.13. 490 t2' MODEL#:2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE W ALL TANK(Sl.[23 CCR§2643 490-15. PANEL MANUFACTURER: 49044' MODEL#(S): IN-TANK PROBE MANUFACTURER: c.WEEKLY 49x16. LEAK TEST FREQUENCY: ❑ a.CONTINUOUS [3 b.DAIL,Y/NIGHTLY ❑ 490.17. ❑ d MONTHLY ❑ e.OTHER(Specify): 490-18, c.OTHER(Specify): 490-19. PROGRAMMED TESTS: __. _.a.0.1Tg_p_h_-__.._....__.... ._b.02 g:F.h-....._...__.-__.....__._...__.__....__.__...._...__-._� 0-90.20. - _............_._.,...._._....,_-__..... 496-21. ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION[23 CCR§21M.11 TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS ago-22. -•_ •.❑ 4. 0-90-23. WEEKLY MANUAL TANK GAUGING(MIG)[23 CCR§260-51 -._.__.__.----_.__.__..._-_-.__...._.....____..-.._....__.__...__.___.._._-_-_.___....._____ 490.24. ❑ 5.TANK INTEGRITY TESTING PER[23 CCR§2643.11 _0-90-x3,._ a ANNUALLY ❑ b.BIENNIALLY ❑ e-OTHER(Specify)• 490-26. _TEST_FREQUENCY:_-__.__._-_�.---._..._._._--___._.---•- ,-.-..-.___.-_____.-_ 490.27. ❑ 99.OTHER(Specify): (Check all that apply V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) 490-23. ❑ 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 490-29, C,PRESSURIZED ❑ d UNDER VACUUM 1� � SECONDARY CONTAINMENT IS: (� a DRY ❑ b.LIQUID FILLED ❑ 49Q_31, 490.3o. MODEL#: S PANEL MANUFACTURER: 1/��d r 007' 490-33. 0-90-32. MODEL#(S): '7 n,.a g��-�� LEAK SENSOR MANUFACTURER: -'- i4 s T ��rj� a.YES ❑ b.NO 490-34. PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. 490-35. FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN_ - ® a.YES ❑ b NO 490-36. 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.17.3 CCR§26361 490-32. {., 'L¢s O O 490-33. MLLD MANUFACTURER(S): p MODEL#(S): IJ _. ------•--.__...__._.--.--._-._. 0-90-39. ❑ 3.ELECTRONIC LINE LEAK DETECTOR(FLED)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.[z3 ccR§26361 490.41 411. MODEL#(S): ELLD MANUFACTURER(S): MINIMUM IMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. 490-02. PROGRAMMED IN LINE LEAK TEST: ❑ a.YES El b.NO 490-43' ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. El a. ❑ a.YES ❑ b.NO ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP ❑ 4.PIPE INTEGRITY TESTING. 490-46• ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 4`> Z.._...... TEST FREQUENCY: ❑ a._ - - 490-43• ❑ 5.VISUALPIPEMONITORING. + 490-49, DAILY a. E] b.WEEKLY ❑ c.MIN.MONTFLI.Y&EACH TIME SYSTEM OPERATED FREQUENCY: ❑ s Allowed for monitoIMg of unbori a�cga!eX..&«� °*f'!ei Piping onlyPer HSC X2528 490-so. t.S�Y�•(3)-,_,-•„-„_.� __..__..._._.__.._.._....._................._....__,...__._._._..__...__.._.___.__.. ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA.[23 CCR§2636(a)(3)] ...._.._.__...___....__._.__.. IS CONNECTED TO THE TANK SYSTEM. _..._............_._. 490-31. ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE DIVISION 20,CHAPTE _... ..._.._.....-......................._._._ -_. ....---......_......_..._,..---.,.__.._._....................... 490.52. 490-53. ❑ 99,OTHER(Specify) UPCF UST-D(1212007)-1/4 www.unidoes.org