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08/2712010 15:25 2093675424 BAGLEY ENTERPRISES PAGE 04105 coRR cE>6'7 as a , A'7 to UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK MONITORING FLAN- PA 1 or.2) TYPE OF ACTION ❑L W PLAN WS.CHANCE OF INFORMATION 4 m PLAN TYPE W1.MONITORING iS IDENTICAL FOR ALL USTs AT THIS FACILITY, (Chock one item only) ❑ 2,THIS PLAN COVERS ONLY TRE FOLLOWING UST SYSTEM(G1' I. FACILM MFORMATION FACILITY In#(AzcMcy Use on(v) — BUSINESS NAME(Same as FACILITY NAME) 3' FsUSINF55StTEADDRESS 5OC7 tAaEST AA �j ClTyfiav H.EQUIPMENT TESTING AND MEVENTIVE MAINTENANCE T Testing,preventive maintenance,and calibration of monitodog equipment(e.g.,senlars,probes,line leek detectors,etc,)must be performed at the f equency specified by the equipmcM:rtenufacturels'ingtrUctioOs,or aftftu»lly,whichever is more frequent and that such work moat Tx pcRormcd by qualified Pcrarnmcl. (23 CCR 2632,2634,2638,2641 MONITORING EQUIPMENT 1S SERVICED 1,ANNUALLY Sl.OTHER(S cctfyY 4499n-s3b4 I III.MONWORITJ19 LOCATIONS 1.NEW SITE PLOT PLANIMAP$UBMITTF.D WITH THIS PLAN. an SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632. 2634)4wA4 m� IV.TANK MONITORING IS PERFORMED USING TEM FOLLOWING . THOD(S): I.CONTINUOUS ELECTRONIC TANK MONI'T'ORING OF ANNULAR(INTERSTITIA.[)SPACF,(S)OR SRCONDARY CONTAINMENT 4"-s VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 R§2632'2w) SECONDARY CONTAINMENT IS: ❑ a.DRY LIQUID FILLED ❑ e.PRESSURIZED ❑d.UNDF..R VACUUM a911.6 PANEL MANUFACTURER: F S"j MODEL#: P"70-- TI;K _ �.. ,. 4-"s LEAK SENSOR MANUFACTURER £BL4.) 49(1-9' MODEL#(S): L..S ❑ 2,AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR J11!O E WALL TANK(S).(23 CCR§2643) PANEL MANUFACTURER: 4Q"-T� MODEL#; IN TANK PROBE MANUFACTURER; _ _IM-14. MODEL#(S); 490-IS !T^ LEAK TEST FREQUENCY; ❑ a,CONTINUOUS ❑ b.DAILY/NTGHTLY ❑ c.WEEKLY 471.16 [I d.MONTHLY� c.OTHER(S.-i�:— 41NW7 PROGRAMMED TESTS: ❑ a.O.lg,p,h. 0,2 G.OTHER(Specify 4M,X_ h400,10 ❑ 3.MONTHLY STATIIMCAI.,INVENTORY RECONCILIATION(23 CCR 12646.1); 490"20 ❑ 4,WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a.36 HOURS El b.60 HOURS n !,—TANK INTEGRITY TFST�NG(23 CCR 12643.1): 4W-23TEST FREQUENCY:a a.ANNUALLY Elb.BIENNIALLY [Ic,OTHER(Specify): 490-U Q 99,OTHER (Specify): 49ti27 V.KM MONITORWNG IS PEP"It.MM USING THE FOLLOWING METSOD(S)(Check all that apply) 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMPS)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND VISUAL ALARMS.(23 CCR§2636) _�/' SECONDARY CONTAINMENT IS;eRY ❑b.I:TQUTn FI1..I.F.D ❑c.PRESSURIZED ❑d.UNDER VACUUM PANEL MANUFACTURER: IU W .� — �•4'N'f ;; MODEL N' AusG -TE =I AK SENSOR MANUFACTURER: -bui 4'm 3a MODEL#(S): LS-.3_ .�.... . A9n -33 LE PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. jaES ❑b.NO 4911.44 FAILUREIDISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN, SK,YES ❑b.NO asuas ❑ 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 30 g.pd1.LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED CCR2636�..,�,,._ �_ MLLD MANUFACTURER(S): 491,17 MODEL,if(S); ��s ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 A.".LEAK TESTS (73 CCR 47616) _ 490-39 _ ELLD M_ANUFACT_URE(t( 1p' 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.� 49Ia4z ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO aW' ELLD FAILUREIDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49f" 4.PIPE INTEGRITY TEST!AG mwls TEST FREQUENCY— W4.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHERS ff) 4�f 4!491e 47 jj 5.VISUAL PIPE MONITORING. 4'XL419 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY k EACH TIME SYSTEM OPERATED* 49049 •Atlowcdrormmi!tn nflmWed or Awl oping oply per HSCisT. OHI ❑ 6.SETCTIO14 PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(®)(3)1. 4vn sa 7,NO REGULATED PIPING PER HEAI,.TH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 49041 [399.OTHER(Specify) 470-53 OM.53 UPCF UST-D(112(2007)1/4