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z UNIFIED PROGRAM CONSOLIDATED FORIW UNDERGROUND STORAGE TANK MONITORING PLAN-JPaLe i 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. 490-2 (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S)- I. FACELITYEWORMATION FACILITY ID#(Agency Use Only) I I I - I I I 1 -1 1 1 1 1 1 1 1 BUSINESS NAME(Same as FACILITY NAME) �'r 3. BUSINESS SITE ADDRESS i5jo CITY 104. H.EQUIPMENT TESTING AND PREVENTIVE NUEVMANCE L 5 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 MONITORING EQUIPMENT IS SERVICED ( 1.ANNUALLY ❑ 99.OTHER(Specify): a�3b III.MONITORING LOCATIONS ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 2634)49o-4 IV.TANK MONITORMG IS PERFORMED USINGTHE FOLLOWING METHOD(S): 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 4-5 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: Eg a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490.6 PANEL MANUFACTURER: ' j j 1 9 A � `ata_ MODEL#: 490-8 LEAK SENSOR MANUFACTURER: L/ _ MODEL#(S): 490.10 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANKIS).(23 CCR§2643) 490-11 PANEL MANUFACTURER: a90-1z MODEL#: 490-13 IN-TANK PROBE MANUFACTURER: a�I0-. MODEL#(S): 490-15 LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490616 ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17 PROGRAMMED TESTS: C3a.0.1 g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): 490-18 490.19 ❑ 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 422 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490'25 490.24 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) CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-25 VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS: a.DRY ❑b.LIQUID FILLED [1c.PRESSURIZED ❑d.UNDER VACUUM 49°29 PANEL MANUFACTURER 490.30 MODEL#: 490-31 LEAK SENSOR MANUFACTURER: 490'32 MODEL#(S): 490-33 PIPING LEAK ALARM TRIGGERS AUTOMATI PUMP(i.e.,TURBINE)SHUTDOWN. a.YES ❑b.NO 490-34 FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. jaa.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 PRODUCT FLOW WHEN A LEAK IS DETECTED23 rCR 263 490-36 MLLD MANUFACTURER(S): 490"37 MODEL#(S): P �' 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) 49040 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. 49042 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490.43 ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑&YES ❑b.NO 49044 4.PIPE INTEGRITY TESTING 49045 TEST FREQUENCY a.ANNUALLY b.EVERY 3 YEARS Q c.OTHERS 49446490.47 5.VISUAL PIPE MONITORING. 490.49 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED' 49049 *Allowed for nwaitoring of unburied emalmey gmmtor fuel piping ordy per HSC 25281.3(bX3) ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(a)(3)1. 49040 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490-51 90- ❑ 99.OTHER(Specify) 433 UPCF UST-D(12/2007)1/4