COMPLIANCE INFO_2008-2018 - Laserfiche WebLink

Home Browse Search

UNIFIED PROGRAM CONSOLIDATED FORM • UNDERGROUND STORAGE TANK MONITORING PLAN-(Pae 1 of 2) TYPE OF ACTION ❑ 1.NEW PLAN 0 2.CHANGE OF INFORMATION ago I. PLAN TYPE 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 ID#(Agency Use Only) 1, BUSINESS NAME(Same as Facility Name or DBA) 3. It LS BUSINESS SITE ADDRESS 103. CITY 104. O® OC d II. 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 b the equipment manufacturers'instructions,or annually,whichever is more frequent.Such work must be performed by qualified personnel.[23 CCR§2632,2634,2_638,26411 MONITORING EQUIPMENT IS SERVICED IR 1.ANNUALLY ❑ 99.OTHER(S 490-34 Pe cif Y) 490-3b. III. MONITORING LOCATIONS ❑ 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN A 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED [23 CCR§2632,26341 494 IV. TANK MONITORING IS PERFORMED USING THE FOLLO G OD(S) 1"O'kall t a0gy 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) 490-5. WITH AUDIBLE AND VISUAL ALARMS.[23 CCR§2632,26341 SECONDARY CONTAINMENT IS: A a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 4906. PANEL MANUFACTURER: Nmr t'-T 2 150 490-7. MODEL#: 'T LS ' ® 490-8. LEAK SENSOR MANUFACTURER: V 0,V (�.i9$� 490-e. MODEL#(S): L4 at 490-10. ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).123 CCR§26431 490-11. PANEL MANUFACTURER: 490-12. 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): 4e0-17. 490-I8. PROGRAMMED TESTS: ❑ a.0.1 g.p.h_ ❑ b.0.2 g.p.h. ,❑ c.OTHER(Specify): 490-19. ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION 123 CCR§2646.11 _ 490-W 490- ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)[23 CCR§26451 TESTING PERIOD: E] a.36 HOURS ❑ b.60 HOURS 490-22. 21. ❑ 5.TANK INTEGRITY TESTING PER[23 CCR§2643.q v 490-23. 490-24. TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 490-25. 99.OTHER(Specify): ® O 490-27.26 ll V. PIPE MONITO G IS PERFO USING T FOLLOWING TIIOD(S) hQt,,Mly IN 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENTITH AUDIBLE&VISUAL ALARMS. 490-28. ,W (23CCR SECONDARY CONTAINMENT IS: ® a.DRY ❑ b.LIQUID FILLED C] c.PRESSURIZED ❑ d.UNDER VACUUM 490-29. §26361PANEL MANUFACTURER: V u&0. INWn 490-30. MODEL# a Ls.zist 490-31. LEAK SENSOR MANUFACTURER: y 2. C0. uca 490-32. MODEL#(S)• AQ 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. W a.YES ❑ b.NO 490-35, 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF 490-36, PRODUCT FLOW WHEN A LEAK IS DETECTED.[23 CCR§26361 MLLD MANUFACTURER(S): Q 490-37. MODEL#(S): 490-38. ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.(23 CCR§26361 9'4Q ®pp 490-39 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 490.43. ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 49044. ❑ 4.PIPE INTEGRITY TESTING. 49045. TEST FREQUENCY: Ela.ANNUALLY_ b.EVERY 3 YEARS 0 c.OTHERS if 49046. ❑ 5.VISUAL PIPE MONITORING. 49048. FREQUENCY: ❑ a.DAILY ❑ b.WEEKLY ` C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 490-49. •Allowed for monitoring of unburied emergency generator fuel piping only per HSC§25281.5(bH3) ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA.123 CCR§2636(aX3)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. C399.OTHER(Specify) 4904-5533. UPCF UST-D(12/2007)-1/4 www.unidoes.org