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94/1712008 20: 05 5107963470 SHARMA PAGE 02
<br /> V� 2�S
<br /> UNIFIED PROGRAM CONSOLIDATED FORM
<br /> UNDERGROUND STORAGE TANK
<br /> MONITORING PLAN- Pae 1 of 2
<br /> TYPE OF ACTION ❑ 1.NEW PLAN �.CHANGE OF INFORMATION
<br /> PIAN TYPE1.MONITORING IS IDENTICAL FOR ALL USTs AT TRIS FACILITY. X0'2
<br /> (Check one item only} ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S):
<br /> I. FACILITY INFORMATION
<br /> FACILITY M#(,4gency Use On10 © o - --t14161+1 3
<br /> 1 BUSINESS NAMF.(.Sama ac Fncfl4 _V(zmw or 1).", 3.
<br /> A&IW STKEET �tA W PM - (-JS EWTEKOMSE L_LX-*
<br /> BUSINES5 51TE ADDRESS 103
<br /> 11 oo S. MhiN S`[SEE T CITYMr�Ft�TEC-A,CA 104,
<br /> II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE
<br /> Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must be performed at the frequency specified
<br /> by the a ui Lenq marrufacturers'irtstruct1011y,whichever is more f"ucm,Such work must beperf»rmed IAvyualified F.CrsonruL Ccx g2w2,tti3a,_633,26411
<br /> MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY ❑ 99.OTHER(Specify): 490-3".
<br /> 4vaab.
<br /> III. MONITORING LOCATIONS
<br /> ❑ 1.NEW SITZ=PLOT PLAN/MAP SUBMITTED WITH TRIS PLAN %2.SITE PLOT PLANAIAP PREVIOUSLY SUBMITTED (23 CCR§X32,-.6341 490.4.
<br /> IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) ty hecckk"4l
<br /> 1.CUNI'INUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECOND,AR�CONTAINNIENT VAULTS) 4905.
<br /> WITH AUDIBLE AND VtSUAL ALARMS:l23 CCR§2632.26341
<br /> SECONDARY CONTAINMENT IS: 'Ka.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 490.6.
<br /> PANEL MANUFACTURER: NEE DER - {LOOT •'90-9 MODEL#: T L_S--3 5a 49C01
<br /> LEAK SENSOR MANUFACTURER: VV _DF_R-�k MT 4904
<br /> MODEL#(S): "I qI i3go - 09 49D-10.
<br /> [ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINQ(E WALL TAM. S).1;3 CCR§26_+31 490.31.
<br /> PANF,LMANTJFACIUKbK 00-1 MODEL#: TLS 490-13.
<br /> iN-TANK PROBE:�LANUF.acTURER: yEEVEfl.-{L0oT 490.14. MODELr#(6_): - v1ACe [3�o_io°J490-15.
<br /> LEAK TEST FREQUENCY: %a.CONTINUOUS Cl b.DAILY/NIQHTLY ❑ c.WEEKLY 490 t6
<br /> ❑ d.MONTHLY ❑ e.OTTIER(Specify). 490-17.
<br /> PROGRAMMED TESTS:_ ❑ a 0.1 g- Il.
<br /> Q-----__❑ b.0.2�P.h_- ❑-c OTHER(SQecit490-18
<br /> _i29-12-
<br /> 0
<br /> i29-12 ._❑ 3 MONTHLY STATISTICAL INVENTORY RECONCILIATION[zlcpt ffa646.i1 490-20.
<br /> ❑ d.WEEKLY MANUAL TANK GAUGING(MTG)123 CCR$2645] TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS
<br /> ------------_-......:---------------,-,.,-------------------_..__..._.------_ ___..,..�-----------,--•------------074_x,,......
<br /> ❑ 5.TANK INTEGRI-1 Y I-ES I'INU.PER(^.1.CCR§,1643.13 490 0-3.
<br /> TEST FRE UENCY: a.ANNTJALLY 490-24.
<br /> --------- __Q.-----_...---- -,,:....-_----._._..__._� b.BL>rNrILALLY _❑.c.OxrLGh_.(,spcci�:_ _.�-. .:...
<br /> ❑ 99.OTHER(5 eclf ): V%5UArL MoNkTO�,%N& •- DAAL`I 4 :
<br /> V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (heck-11
<br /> 1.CONTINUOUS MON-fTORING OF PIPF/PIPING SUNIP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 100-M
<br /> SECONDARY CONTAINMENT IS: ❑ a.DRY [] b.LIQUID FILLED ❑ c,PRESSURIZED ❑ d.UNDER VACUUM 490.29.
<br /> PANEL MANUFACTURER: E QQoT 4.00-310 MODEL [L S-'5510 490-11.
<br /> LF-AK SENSOR MANUFACTURER: MODEL q p- 2,$ 490-33.
<br /> PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e..TURBINE)SHUTDOWN. a YES ❑ b.NO 491114,
<br /> _ FAILUR,E/DISCONNECTION OF TIIE MOMTORING_SYST_EM_I K10j KS AUTOMATIC PUMP SHUTDOV9X a YES [Ib.NO dA0 35
<br /> 2,MECHANICAL LINE LEAK DETECTOR(MELD)TFLAT ROU >L
<br /> TINY PERFORMS 3.0 g,p.h.L>XVTIFSTS�16 RE9IRIC CS OR SHVTS OkF 499-36
<br /> PRODUCT FLOW WHEN A LEAK IS DETECTED.(23 rcR4:6361
<br /> -_MANUFACTL•RER(S : MZ FE FE TRO 49o_1v. MODEL#(S): CR 1w�20aU g�P ML-D 490--
<br /> --------_._...w.--
<br /> ❑ 3.ELECTRONIC LINE LF,AK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p h,LEAI{TESTS.(23 ccta6263615k* 0-7 6 q D cH j 490.39.
<br /> ELLD MANUFACTURER(S): 490.40' MODEL#(S): 49"2.
<br /> PROGRAMMED IN LINE LEAK TEST: ❑ a 10INIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0:1 g.p.h. 490.42.
<br /> ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PI,IMP SHUTDOWN, ❑ a.YES ❑ b.NO 490"43
<br /> ELLD FAILURF/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a YE5 ❑ b,NO 4 44
<br /> _4_'F INTEGRITY TESTING. ,- ----....-_._._490-45 .
<br /> TEST FREQUENCY; ❑ a.ANNUALLY ❑ b.EVERY_3 YEARS ❑ C.OTHERS ctty) 49046.
<br /> -------- --------.,.------.----.�.�_,.P�-_ _-.9047.
<br /> ❑ 5. VISUAL PIPE MONITORING. .4,90.-43.
<br /> FREQUENCY: a,DAILY ❑ b.WEEKLY ❑ c.,WN,MONTHLY&.EACH TIME SYSTCM OPERATED
<br /> , • 490.49.
<br /> _
<br /> 6.❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA,ID CCR 92636(#2)3 49a.w.
<br /> 1.NO FEdULATF.D PIPINQ PBR HEALTH AND SAFETY CODE,LIIVISIUN:A,CHAPTER 6.7 IS CONNECTED TO THE TANK SXSTEM. 490.51.
<br /> Q 99.OTHER lS ecify
<br /> 49
<br /> UPCF UST-D(12/2007)-1/4 www,unidoa.org
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