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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING PLAN-(Page 1 of 2) TYPE OF ACTION ❑ 1.NEW PLAN ® 2.CHANGE OF INFORMATION 490-1 PLAN TYPE ® 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. RECD JUL 490-2 deck one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM($- I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) BUSINESS NAME(Same as FACILITY NAME) Yosemite 76 #255417 _ BUSINESS SITE ADDRESS 1700 East Yosemite Avenue 103, CITY Manteca I04. 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 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)___ _ - p - ---3a MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY ❑ 99.OTHER(S eci ): 490-3a 490-3b III. MONITORING LOCATIONS ® 1.NEW SITE PLOT PLAN/NIAP SUBMITTED WITH THIS PLAN. ❑ 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITI-ED. (23 CCR§2632, 2634)490-4 IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): ® I.CONTINUOUS ELECTRONIC TANK NIONIT 0 R WING OFAIN ULAR(INTERSTITIAL)SPACE(S)OR SECONDARY C0NTA INNIENT 490-5 VAULT(S)WITH AUDIBLE AND VISUAL ALARNIS. (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: ® a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490-6 ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ 490-7 ! 490-8 PANEL MANUFACTURER -Veeder Root MODEL#: TLS-350 --- ------------------------------------- -----t--------------------------------------------------------------------------------- LEAK SENSOR MANUFACTURER Veeder Root ago 9 ! MODEL#(S). 794380-420 490-10 ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 490-11 PANEL MANUFACTURER: 490-12 MODEL#: 490-13 --------------------------------------------------------------------------------------- - - --15 IN-TANK PROBE MANUFACTURER: ------------------------------------- -- leo-ia MODEL#(S): 490-------------------------------- ---- --------------------- ------- ------------------------- ---------------- - ----------------------------- LEAK TEST- -FREQUENCY:- -- -------r-1-- - a.CONTINUOUS- ---------------------------------------[I -- b.DAILY/NIG HTLY ❑ c.WEEKLY 490-16 ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17 --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------18 PROGRAMMED TESTS: ❑ a.0.1 h. ❑ b.0.2 g. h. ❑ c.OTHER(S eciqq 490-18 g.p. p. p `7,) 490-19 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 49°•20 L] 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: E] a.36HOURS [3b.60 HOURS 490-21 90 22 ❑ 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 TEST FREQUENCY: Ela.ANNUALLY El b.BIENNIALLY El c.OTHER(Specify): 4990-25 490-26 ❑99.OTHER (Specify): 490-27 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) ® 1.CONTINUOUS MONITORING OF PIPE/PIPING SUNIP(S)AND OTHER SECONDARY CONTAINNIENT WITH AUDIBLE AND 490.28 VISUAL ALARNIS. (23 CCR§2636) SECONDARY CONTAINMENT IS: Na.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM a9o•z9 -------- --------------------------------------------------------------------------------------------------------------------------- ------ - - 490-30 -31490 PANEL MANUFACTURER: Veeder Root MODEL#: TLS-350 - ----------- - - ----------------------------------------------------------------•------------------------ 490-32 1490-33 LEAK SENSOR MANUFACTURER_ Veeder Root _______i MODEL#(S) 794380-208 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(NILLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED 23 CCR 2636 490-36 -------------------------------------------------------------- - --- -(----------- 490-- - MLLD MANUFACTURER(S): Va orless 490' MODEL#(S): LD2000 490 38 ❑ 3. ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490-39 - ---------------------------------------------------------------- - --*----------------------------------------------------------------------- ELLD MANUFACTURER(S) 490-40 I 440-41 MODEL#(S): ----------------------------- ---------------- --- - ----- ---------------------- -- ------ -- ) 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 FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑b.NO 4904 ❑ 4.PIPE INTEGRITY TESTING 490-45 TEST FREQUENCY ❑ a.ANNUALLY ® b.EVERY 3 YEARS ❑ c.OTHER(Specify) 490-46490-47 ❑ 5.VISUAL PIPE MONITORING. 490-48 FREQUENCY [:] a.DAILY [Ib.WEEKLY [-]c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED` 490-49 i Allowed for monitoring of unburied emergency generator fuel piping only per HSC§25281.5(b)(3) 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 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 490-51 490-52 ❑ 99 OTHER(Specify) 490-53 UPCF us"r-D(12/2007) it