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WIFIED PROGRAM CONSOLIDATED FORD' UNDERGROUND STORAGE TANK MONITORING PLAN-(page 1 of 2) TYPE OF ACTION ❑1.NEW PLAN ❑ 2.CHANGE OF INFORMATION 490-1 PLAN TYPE S 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490.2 (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S)- I. FACILITY INFORMATION FACILITY M#(Agency Use Only) BUSINESS NAME(Same as FACILITY NAME) Safeway Fuel Station 2707-10 3. BUSINESS SITE ADDRESS 6425 Pacific Ave. -0-1.CITY Stockton 104' EL EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detector;,etc.)must be performed at the frequency specified by the equipment manufacturers'instructions,or annually,whichever is more frequent,and chat such work must be performed by qualified personnel. 23 CCR 2632,2634,2638,2641) MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY ❑ 99.OTHER(Specify): 490-3. M.MONITORING LOCATIONS ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. X 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 2634)4901 IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(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: S a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490'4 PANEL MANUFACTURER Veeder Root TLS-350R 4904. MODEL#: 848290-012 4963 LEAK SENSOR MANUFACTURER: Veeder Root 490-9' MODEL#:794390-460 490-10 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(n(23 CCR§2643) 49x11 PANEL MANUFACTURER 49011 MODEL#: 490-13 IN-TANK PROBE MANUFACTURER 49014. MODEL#(S): 490-15 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILYINIGHTLY ❑ a WEEKLY 49016 ❑ d.MONTHLY ❑ e.OTHER(Specify). 490-17 PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 gp.h., ❑ c.OTHER(Specify): °49900_�y ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 69020 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§26451 TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 490-21 490.22 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490.23 TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 490.24 490.25 ❑ 99.OTHER (Specify): . . 490-26 49x27 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Cheek all that apply) 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490.29 VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS:S&DRY ❑b.LIQUID FILLED [1c.PRESSURIZED ❑d.UNDER VACUUM 490x9 PANEL MANUFACTURER Veeder Root TLS-350 990'30 MODEL#: 848290-012 490-31 LEAK SENSOR MANUFACTURER Veeder Root °9°x2 MODEL#:794380-208 490.33 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. S a.YES ❑b.NO 49-134 FAILUREMISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. M a YES ❑b.NO 49635 2.MECHANICAL LINE LEAK DETECTOR(mLLD)THAT ROUTINELY PERFORMS 3.0 g.ph.LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK LS DETECTED CCR 263 49 W MLLD MANUFACTURER(S): 490-37 MODEL#(S): 49038 S 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2616) 49039 ELLD MAM)FACTURE S Veeder Root 490'40' MODEL#(S): 848480-001 490.41 PROGRAMMED IN LINE LEAK TEST: S 1.MINIMUM MONTHLY 0.2 g p.h. S 2.MINIMUM ANNUAL 0.1 g p.h. 09012 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. X a.YES ❑b.NO 490x3 ELLD FAILUREIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. x a YES ❑b.NO 490-44 ❑ 4.PIPE INTEGRITY TESTING 490.45 TEST FREQUENCY ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHERS CCI 490/6490.47 5.VISUAL PIPE MONITORING. 490-08 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C.MON.MONTHLY&EACH TIME SYSTEM OPERATED" 49019 �Aaowed Po,7PWt,rM ofunduied mmwcy genmtor Pool pi*2 mly W ASC 25261.5 3 ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA(23 CCR§2636(a)(3)1. 490.50 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490.51 ❑ 99.OTHER(Specify) _ - 490.M 490.53 UPCF UST-D(122007)1/4