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NICK ARBABIAN 2 4729584 p.5 <br /> ip <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN- ge i of <br /> TYPE OF ACTION EW PLAN ❑ 2.CHANGE OF INFORMATION 490.1 <br /> PLAN TYPE 1,MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490 2 <br /> (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S)- <br /> 1. FACILITY INFORMATION <br /> FACILITY ID#(Agency Use Only) - <br /> BUSINESS NAME(Same as FACILITY NAME) IN r`_0- S��sX,(� 3 <br /> BUSINESS SITE ADDRESS l b S� H A F�"NJ rz-b 103 C1TY LATH rW 4 S '3 J 104. <br /> IL EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE <br /> Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must be performed at the frequency <br /> specified by the equipment manufacturers'instructions,or annually,whichever is more frequent,and that such work must be performed by qualified personnel. <br /> (23 CCR§26M 2634,2638,264-11 <br /> MONITORING E IPMENT IS SERVICED 1.ANNUALLY ❑ 99.OTHERS 490-36 <br /> QU ( p�IfY): 490-3b <br /> IlI.MONIT-O LOCATIONS <br /> 1.NEW SITE PLOT PLANIMAP SUBMITTED WITH THIS PLAN. 2-SITE PLOT PLANJMAP PREVIOUSLY SUBMITTED. (23 CCR§2632, <br /> 2634 90-0 <br /> LV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): <br /> l.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 4-M-5 <br /> VAULT(S)WITH AUDIBLE AND VISUAL Aj ACRMS. (23 CCR§2632,2634) <br /> SECONDARY CONTAINMENT IS: - a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 49" <br /> --- -_ _ _ - ------- ---- - -_ __---- 4%0. I- --- --------------------•---------------•-_ - --- -R <br /> PANEL MANUFACTURER: �/ �c?TZ-RtzT T - MODEL k_.T4S�__3537___.-_.._-_-_-_-____-__.------ <br /> LEAK SENSOR MANUFACTURER: A/�~I��Y1,�Y2 t?(1T -- 411"-9. i MODEL#(S): "' [] 490.16 <br /> 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TAMS (73 CCR§2643) 490.11 <br /> PANEL MANUFACTURER: 490-12 MODEL#: 490-13 <br /> IN-TANK PROBE MANUFACTURER: 4"-14' MODEL#(S): 490-15 <br /> LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILYIMIGHTLY ❑ c.WEEKLY 490.16 <br /> ❑ d.MONTFll Y ❑ e.OTHER(Specify): 490417 <br /> PROGRAMMED TESTS: ❑ a•0.1 h. ❑ b.0.2 h. ❑ c.OTHER490-19 <br /> g•F• g•F- (Specify),. 491x19 <br /> 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490-20 <br /> ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 490-21 <br /> 490-22 <br /> 5,TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 <br /> TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c-OTHER(Specify): 490-24 <br /> 49ir-0-5 <br /> 490.26 <br /> ❑ <br /> 99.OTHER (Specify): 490-27 <br /> 1-1 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) <br /> 3.CONTINUOUS MONITORING OF PIPE!PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490.23 <br /> VISUAL ALARMS. (23 CCR§2636) -- <br /> SECONDARY CONTAINMENT IS:[Ra.DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM 490-29 <br /> PANEL MANUFACTURER: 4 :nLaOT 4"0-30MODEL#: T.Sj-- r 7j - 490-31 <br /> LEAK SENSOR MANUFACTURER: %jg2ML7,Y7--a00'T -T -100-32 MODEL#(S): jI-S_3J�+ 490-33 <br /> ---_ ------- ---- - - --- -- -------- <br /> PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. �a YES ❑b.NO 490-34 <br /> 1-4tc[� <br /> FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. vYES ❑b.NO 490.35 <br /> 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.p.b.LEAK TESTS AND RESTRICTS OR SHUTS OFF <br /> - PRODUCT FLOW WHEN A LEAK ISAETECTED X23 CCR§2636) -_--- --- -...........-.................•................................ 490-36 <br /> MLLD MANUFACTURER(S): 490-37 MODEL#(S): 490-38 <br /> ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g p b.LEAK TESTS (23 CCR§2636) 490-39 <br /> -__ -_--- -- _ -_-_------_ -- - - - - - -- ------------------------- <br /> ELLD MANUFACTURER(S) 4x.40. E MODEL#(S): 490-41 <br /> PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. 49042 <br /> ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490.43 <br /> ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 414 <br /> 4.PIPE INTEGRITY TESTING 491)-4s <br /> TEST FREQUENCY ❑ a.ANNUALLY Ej b.EVERY 3 YEARS ❑ c.OTHER(Specify) 490-46490-0-7 <br /> Lik-5.VISUAL PIPE MONITORING. / 490-48 <br /> FREQUENCY ❑ a.DAILY [3b.WEEKLY a MIN.MONTHLY&EACH TCMESYSTEM OPERATED* 490-49 <br /> •Alloxred r1"molatori of lelbwi4d wfi,el '' rm HSC25281. 3 <br /> ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(6x3)1. 490-50 <br /> 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM <br /> 49051 <br /> 99.OTHERS 4rn>•s2 <br /> ❑ (Specify) 690-53 <br /> UPCF UST-D(12/1007)114 <br />