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AL MW UNIFIED PROGRAM CONSOLIDATED FO UNDERGROUND STORAGE TANK MONITORING PLAN- Pae 1 of 2) TYPE OF ACTION ❑1.NEW PLAN 197 2.CHANGE OF INFORMATION 2008 490-1 0-1 PLAN TYPE 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. az EALTH (Check one item onl ) 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM( • f f� I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) I I I - -1 1 BUSINESS NAME(Same as FACILITY NAME) Lodi Memorial 3 BUSINESS SITE ADDRESS 975 S. Fairmont Ave. t03 CITY Lodi 104. H.EQUEPNIENT TESTING AND PREVENTIVE ENANCE 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 annually,whichever is more frequent,and that such work must be performed by qualified personnel. 23 CCR§2632,2634,2638,2641 490-30- MONITORING EQUIPMENT IS SERVICED ® I.ANNUALLY ❑ 99.OTHER(Specify): 490-36 III.MONITORING-LOCATIONS ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN.X8 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 2634)490-4 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: ® a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490.6 PANEL MANUFACTURER 490-7. MODEL#: 7 Q 49M LEAK SENSOR MANUFACTURER: EBW 490-9. MODEL AS): LS -3A 490-10 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK&(23 CCR§2643) 490-11 PANEL MANUFACTURER: " ' MODEL#: 490-13 IN-TANK PROBE MANUFACTURER: 490-14. MODEL#(S): 490-15 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490'16 ❑ d.MONTHLY ❑ e.OTHER(Specify): 490'17 490-18 PROGRAMMED TESTS: ❑ a.0.1 g.p.h. ❑ b.0.2 g.p.h ❑ c.OTHER(Specify): 490.19 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490.20 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a 36 HOURS ❑ b.60 HOURS 4 22 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490.23 490-24 TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 490,25 490-26 ❑99.OTHER (Specify): 490-27 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) I.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-28 VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS:Ma.DRY []b.LIQUID FILLED []c.PRESSURIZED ❑d.UNDER VACUUM 40 29 PANEL MANUFACTURER EBW 490-30 MODEL#: 9 7 Q 49031 LEAK SENSOR MANUFACTURER EBW 490'32 MODEL#(S): LS-3A 490-33 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ❑a.YES ❑b.NO 490-34 FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490-35 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.p L LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED 23 CCR IM10490.36 MLLD MANUFACTURER(S): 437 MODEL#(S): 490-38 ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 gp.h.LEAK TESTS (23 CCR§2636) 490-39 ELLD MANUFACTURER(S) 440' I MODEL#(S): 490-41 PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. 490.42 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490-43 ELLD FAILUREIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490-44 4.PIPE INTEGRITY TESTING 490-45 TEST FREQUENCY a.ANNUALLY XX b.EVERY 3 YEARS c.OTHERS i 49046 490-47 5.VISUAL PIPE MONITORING. 490-08 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED' 49°49 •Allowed for muni of vaburiad Coal ' ' ail HSC 25281.3 3 ® 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(a)(3)]. 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) 4W53 UPCF UST-D(12/2007)1/4