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i9�re1l1011 03:38 9252926074 GDF -SOLUTIONS FAX PAGE 04/15 <br />r .�. <br />F[GD PROGRAM CONSOLIDATEit FORD <br />UNDERGROUND STORAGE TANK <br />MONITOR NG CLAN - 1o(.2 <br />TYPE OF ACTION ❑ 1, NEW PLAN M 2. CHANGE OF INFORMATION <br />490.1 <br />PLAN TYPE ® 1. MONITORING IS IDENTICAL FOR ALL UST" AT THIS FACILITY. <br />{C halt onz item oni) ❑ 2. THIS PLAN COVERS ONLY THE FOLLOWING UV SYSTEM{Sk <br />L FACILITY XNSORMATTON <br />a9az <br />FACILITY IDA (Agency Use On T.r <br />8118INESSNAME(SassFAC)LI'TY.NAMB) CountryC1076 <br />3 <br />auSINESSsTTE ADDRESS 2575 Country Club Blvd. 143 CITY Stockton <br />149 <br />M EQ wMNT TESTING AND PREVENTME MAINTENANCE <br />Testing, prev*Vive MWMOM wd caiibMlion of manfto ln0gWpMM (e g, sensors. probes, line leak detectors, oc.) must be pcffbrmed at an ffdqu=y <br />spmhw by ta of af=aily, whichever is more frequent, and that "etch work must be pe+farmcd b Lisvd <br />i73 CCR §2632. TPL 263&, 2641) Y q ice• <br />MONITORING EQVXPWNT IS SMVLCED ® 1. ANNUALLY L j 99. OTHER (welry): <br />IPOs. <br />490:30 <br />EEL MO)WWRIKC LOCATION'S <br />Q I. NEYY sm PwT FLANtmAP siA3i1'Imm WTTII THIS I'i.AN. ® z. SITE PLOT PLA3Yf W pRMOTISi.Y suffm rF.D. (23 CCR 12M <br />IV TANK MONFPORING IS PERWRMEA USYNG TIM POLLOWIiNG METHOD(S)1 <br />-NIC <br />I. MTNT3b S BIM EM T K MONI TORR OF ANNULAR (11111 i ti STIT AL) SFACEM OR SECONDARY CONTAINMENT T <br />VAULT(S) WITH AUDIBLE AND VISUAL ALARMS (23 CCR ¢2631, 7.634) <br />SEC ONI)AXY CONTAINMENT IS: a. DRY ;_ b. LIQUID FILLED ❑ c. PRESSURt MD ❑ d. UNDER VACUUM <br />49C�-5 <br />4OU <br />PANEL MANUF'ACTt ALFA:• IVeMar Root "0-7 1 MODEL #• TLS-35OR <br />' <br />LEAK SENSOR MANUFACTURER Veeder Root 490.9. MODEL NS): 794M420 <br />494.10 <br />2. AUTOMATIC TANK U1550mr. (AT ) SYSTEM -USM TO MONITOR SiI11GLE Mal JANKt%,(23 CCR, $2643) <br />PANEL MANUPACTURMt 494.u, MODEL 0: <br />"99.21 <br />4"43 <br />A4 -'SANK PR *E_ MANUFACTURER. c9ao<. MClDEi. tiiSJs <br />490.1" <br />LEAK TEST FREQUENCY; C3 a. CONTINUOUS D b.1)AILY/NIGHTLY WEIMLY <br />❑ d. MONSTTI.Y CJ e. OTHER (Specify): <br />4W16 <br />494.17 <br />PROGRAMNZ13 TESTS: ❑ a. 0.1 g p h. ❑ b. 0.2 ph. ❑ c. OT MR (specify):19 <br />a�94a <br />❑ 3. MONTHLY$FATISTICAL VIVENTORY RECONCILIATION (23 CCR I264")C <br />4WO-M <br />E3 4. WEBKLY AL TANK GAUGING y (23 CCR ), TF-TTING PERIOD: [] a. 3614OURS ❑ b, 6Q HOURS <br />"0.21 <br />S. TANK INTEGRITYTEXI= (23 CCR )1 <br />TEST FREQUENCY: ❑ a. ANNUALLY ® b. BIENNIALLY ❑ a OTHER (Specify): <br />PH - <br />® 99. OTHM (Specify): S Ml_TLC tv <br />4WW <br />44a.2s <br />V. PVZ,M0P1=RWG IS PEPJ'ORMKD USING TM FOLLOW1140 OD(S) (C:heek all that a <br />1. CONE" T33QUOUS IMOmmitING OF PIpFJ PIPING RURP(S) AND OTHER SECONDARY CONTAINMENT' WITH AUDIBLE AND <br />VISUAL ALARMS. (23 CCR ¢2636) <br />SECONDARY CONTAINM8NT IS: ®a. DRY ®b. LIQUM Fal= ©c. PRESSURMED Qd. UNDER VACUUM <br />4 <br />PANEL MANUFACTURE& Veedec Root 496.74 ' MODEL #: TLS -MOIL <br />LEAK SENSOR MANUFACTURER: Veeder Root 49oaz <br />MODEL if(S): 794380.2081304 <br />49m 33 <br />PIPING LEAK ALARMTRIGG$)tS AUTOMATIC PUMP (i.e, TURBINE) SHUTDOWN. ® A. YES ❑ b. NO � <br />FAIL13RB1D159CONNSCTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SIiUTDOWN. ®a. YES ❑ b. NO <br />411.34 <br />40"1 <br />2 MECHANICAL I NS LEAlK DETECTOR (MLLD) THAT ItoVTLNELy PERFORMS 3.9 S+A. LEAK TESTS AND RESTRICTS OR SHUTS OFF <br />PRODUCT n)DNV WfftN A BEAK I5DE7 ECTED = 36 49036 <br />MLLD MA1�tU&ACTUREA(S): $7 -Vs Crleal911$tDfeS0I -Red Jacket 490.37 MODEL N(S): LD20001FRIV <br />s9a:3a. <br />❑ 3. ELECTRONIC LM LLEAK UEr'TKCM`OR (ELLD) TRAT RO'L±'IiIV9LY PERFORMS - <br />3.0 g.ttt. 1rFiAlt TEM (13 CCR. §W4) <br />• , " <br />69Q$9 <br />ELLD MAMFACt`URE") 494 gQ <br />49"l <br />PROGR.4Mt = IN LINE LEAK TEST: ❑ I. MINIMUM MONnILY 02 g pit. ❑ 2. MINIMUM ANNUAL. 0,1 g p h. <br />ELLD DL CTiON OF A. FRITN I LEAK TRIGGERS AUTOMA'T'IC PUMP SHUTDOWN. 0S. -YES ❑ b. NO <br />ELLD PAILURMISCONNECTTON TRIGGERS AUTOMATIC PUMP SHUTDOWN. 13& YES O b. NO <br />49342 <br />490-43 <br />499.44 <br />PIPE INTWRnY T'E8TING 49045 <br />TESTF UENCY a ANNUALLY b. EVI~RY 3 Yr -ARS ❑ c. OTH1aR ) 4004" 490-47 <br />5. VISUAL PIPE Mcr{1iLTORiNG, <br />FREQUI04CY ❑ a. DAILY ❑ b. WVEKKLY [] c MIN. MoNr;: y dt VACH TIME SYSTEM OPERATED* <br />A>lawe6flr QfulelMxicdmt i1ui Ih'On- 1LSC 1. 1 <br />❑ 6. SUCTION PMG *MTS 1F.IKiSMnWN CRITEXUA.I2,3 CCR §7.E36(a)(3)]. <br />a90+fa <br />490-47 <br />499"6 <br />7. NO REGULAT ET3 P"(; PER tEALTH AND SAFETY CODE. DIVISION 20, MA­PML7 IS CONNECTED TO THE TANK SY5"i`EM <br />+r9o.fe <br />❑ 99- OTM (SP dry) <br />490-52 <br />a90.yy <br />UST Response Nazi (MODS) 313 <br />