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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN - Pae 1 of 2 TYPE OF ACTION ❑ L NEW PLAN ® 2.CHANGE OF INFORMATION 490-1 PLAN TYPE ® I.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY 400-2 (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) - BUSINESS NAME(Same as Facthry Name or DBA) USA/Tesoro 68153 BUSINESS SITE ADDRESS 2448 W. Kettleman Lane 103 �Crry Lodi 104 U. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must be performed at the frequency specified by the equipment manufacturers'instructions,or annuals whichever is more frequent.Such work must be performed by qualified personnel[zl cca§2631,2634_.63s,zwi J MONITORING EQUIPMENT IS SERVICED C1L ANNUALLY ❑ 99.OTHER(Specify): 490-3 490.36b III. MONITORING LOCATIONS ❑ 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN ® 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED [23 C1711§26.12,26141 490-4 IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) y0-(Check l° I I.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) 490-5 WITH AUDIBLE AND VISUAL ALARMS.(23 CCR§2612,26341 SECONDARY CONTAINMENT IS: ® a.DRY ❑ b.LIQUID FILLED ® c.PRESSURIZED ❑ d.UNDER VACUUM 490-6 PANEL MANUFACTURER: Gllbarco 490.7 MODEL* EMC 490.8 _ LEAK SENSOR MANUFACTURER: Veeder Root 490-9 MODEL#(Si: 794390-409 490-10 -0-2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).123 CCR§26431 460-(1 PANEL MANUFACTURER: 490.12 MODEL#: 4`/0'1i IN-TANK PROBE MANUFACTURER: 490.14 MODEL#(S): 4'"1-11 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DALLY/NIGHTLY ❑ c.WEEKLY 490.16 ❑ d.MONTHLY ❑ e.OTHER(Specify): 490.13 PROGRAMMED TESTS: ❑ a.0.1$.p•h. ❑ b.0.2g.p.h ❑ Oeci 490.1 it ..---. _.._----------. ._._- gP c _-- (-THER SP,�Y)� 490--re _ ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 ccit§two i 490.20. ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)123 ccR§26451 TESTIN_G PERIOD: ❑ a.36 HOURS ❑ b.60 HOUK� 490 ❑ 5.TANK INTEGRITY TESTING PER[23 ccR§26431] 490-1-1 TEST FREQUENCY__ - ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): -4�4 0-24 2 5 490.26 ❑ 99.OTHER(Specify): 490.27 V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) ((Ch-k-11 ® 1.CONTINUOUS MONITORING OF PIMPIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 490-28 [23 CCR SECONDARY CONTAINMENT IS: ® a. Q DRY ❑ b.LIQUID FILLED ® c.PRESSURIZED ❑ d.UNDER VACUUM 490.29 §2636) PANEL MANUFACTURER:Gilbarco 490-10 MODEL#: EMC 490-31 LEAK SENSOR MANUFACIUKEK: Veeder Root 490-32 MODEL.#(S) 794380-208 490.33 PIPING LEAK ALARM TRIGGERS AUTOMA I IC PUMP(i.e.,TURBINE)SHUTDOWN. ® a.YES ❑ b.NO 490x4. FAILURE/DISCONNECTION OF THE MONITORING SYSTEM__TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.YES ❑ b.NO 490.11 I ® 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF 490:6 PRODUCT FLOW WHEN A LEAK IS DETECTED.(23 CCR§26361 MLLD MANUFACTURER(S):Vaporless 490-37 MODEL#(S): LD2000 490.38 ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.[13 CCR§16161 490 19 I ELLD MANUFACTURER(S): 490.40 MODEL#(S): 490-41 PROGRAMMED IN LINE LEAK TEST: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. 490-42, ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 411-43 ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a YES ❑ b.NO 4904 ❑ 4.PIPE INTEGRITY TESTING. -_- - -- -------- 49iLJs TEST FREQUENCY: _ ❑ a.ANNUALLY C3 b.EVERY 3 YEARS ❑ c.OTHER(Specify) 490�°7-'t6 ❑ 5.VISUAL PIPE MONITORING a�=48 FREQUENCY: ❑ a.DAILY ❑ b.WEEKLY ❑ C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED. 490.49 Mimed for monil onng ofunburied eme a- gmmtor Rid Qeing only per HSC§25281.1(6x3) ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERLA.[23 cca§2636(ax3)] 490-50 ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM. 490-51 490.52 ❑ 99.0THER(Specify) 49n-s3 UPCF UST-D(12/2007)-117 www.unidocs.org