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298253593 ENGINEERING DEP 0 4 p.m. 09-10-2010 2/6
<br /> UNIFIED PROGRAM CONSOLIDATED FORIA
<br /> UNDERGROUND STORAGE TANK
<br /> MONITORING PLAN (Pae I of 2)
<br /> TYPE OF ACTION ❑ 1,NEW PLAN ®-2.CHANGE OF INFORMATION 490.1,
<br /> PLAN TYPE ® 1.MONITORING IS IDENTICAUFOR ALL USTs AT THIS FACILITY. 490-2•
<br /> (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S):
<br /> L FACILITY INFORMATION
<br /> FACILITY ID#(Agency Use Only) 1-
<br /> BUSINESS NAME(Same asFacility Name orDBA) Karr Manteca Medical �:ennter 3
<br /> BUSINESS SITE ADDRESS777 W.Yosemite Ave tOt CITY Mantecca 104
<br /> II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE
<br /> Testing,preventive maintenance,and calibration of monitoring equipment(o.g„sensors,probes,line leak detectors,etc.)must be performed at the frequency specified
<br /> J lte ex uiE,n�tl mauufacturets'insuuctiuns:or,annua11y1!! cbever,iv_morc freyucnt.Such work must be� otmed b gtutlif d P CC•1t 42632,2634,2634.26417
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<br /> MONITORING EQUIPMENT IS SERVIC D L ANNUALLY ❑ 99,OTHER(Specify): avow
<br /> � � a90-3b.
<br /> III. MONUORINGLOCATIONS -
<br /> ❑ t.NEW SITE PLOT PLAN/MAP SUBMITTED WITFI THIS PLAN ® 2,wre PLOT PLAN/MAP PREVIOUSLY SUBMITTED [sa CCR§2632,2634) 490-.
<br /> IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) ,,,qp all
<br /> 1.CONTINUgUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULTS) 490-5,
<br /> WITH AUDIBLE AND VISUAL ALARMS.123 CCR§2632,2634]
<br /> SECONDARY CONTAINMENT IS: ❑ a,DRY ® b,LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 4"-
<br /> PANEL MANUFACTURER: Owens Corning 490-1, MODELM Owens Corning 4"0'8'
<br /> mm LEAK SENSOR MANC1FACTURER: Owens Corning 490.9. MODEL: Brine 1OR 490-10.
<br /> ❑m2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(.[z3 ccR§z 3] 49041.
<br /> PANEL MANUFACTURER; 412. MODELM 490-13'
<br /> IN-TANK PROBE MANUFACTURER 490-14, MODEL#(S): 490-15,
<br /> LEAK TEST FREQUENCY: ❑ a,=LY
<br /> UOUS ❑ b.DA1LY/NIGHTLY ❑ c.WEEKLY 490.16.
<br /> d. ❑ e.OTIiER(Specify); 490-17,
<br /> PROGRAMMIEDTESTS: ❑ a.0.1gol. ❑ b.0-2 g.p.h. ❑ c.OTHERS ecit• 499.
<br /> ❑ 3.MONTHLY_STA'CISTIEL_INVENTORY RECONCILIATION[23 cCR 12646,1] 490-20,
<br /> �© 4.WEEKLY MANUAL TANK GAUGING(MTG)1[23 CCR§2045] 4 -�� TESTING PERIOD: ❑ a.36 HOURS _.® .b.6.. .,..�"���R a„"_._.........49-22.
<br /> 490 21.
<br /> 0 HOURS 490-zz.
<br /> .® 5.TANK INTEGRITY TESTING PER 123 CCR§2693,11 490-23.
<br /> ANNUALLY ❑ b,BIENNIALLY c.OTHER(Specify) 0490'24•TEST FREQUENCY:
<br /> zs.
<br /> ❑ 99.OTHER(Speeify): 4400,20.
<br /> V. PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (check-"
<br /> 0 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 490-11.
<br /> [23 CCR SECONDARY CONTAINMENT IS: ® a„DRY 490-;9,
<br /> 936361 ❑ b,LIQUID PILLED ❑ c.PRESSURIZED ❑ d.UNDP R VACUUM
<br /> PANEL MANUFACTURER: 490-30. MODEL II: 490-31.
<br /> LEAK SENSOR MANUFACTURER: 490-32. MODEL#(S): 490-13,
<br /> PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN, ❑ a.YES [0 b.NO 490-34.
<br /> FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN, ❑ a.YES 0 b.NO 490.35'
<br /> ❑ 2.MECHANICAL LME LEAK DETECTOR(MELD)THAT ROUTINELY PERFORMS 3.0 g.p,h;LEAK TESTS AND RESTRICTS OR SHUTS OFF 49x36.
<br /> PRODUCT FLOW WHEN A LEAK IS DETECTED,(23 CCR926361
<br /> MELD MANUFACTURER(Sp ,'�' 490 3�. MODEL#(S);
<br /> ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLO)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS,[v CCR§2636] -4 -39'
<br /> ELLD MANUFACTURER(S): 490.40, MODEL#(S): 490-41,
<br /> PROGRAMMEdIN LINE LEAK TEST; ❑ a.MINIMUM MONTHLY 02 g.p.h, ❑ b.MINIMUM ANNUAL 0.1 g.p.h. 490-42.
<br /> ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a,YES ❑ b.NO 410.43
<br /> ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN, ❑ a,YES ❑ h,NO
<br /> .,...._..............-........_....._..................-- -----
<br /> ❑ 4.PIPE INTEGRITY TESTING. 41)1-45.
<br /> 490 4�,
<br /> UALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specily)
<br /> Amm �TEST FREQUENCX,...___....._.......®,a.ANN ..____-.__.._........-.-.-....
<br /> ❑ 5,VISUAL PIPE MONITORING. - 490-4a,
<br /> FREQUENCY; ❑ a.DAILY [ b.WEEKLY ® C.MIN,MONTHLY R EACH TIME SYSTEM OPERATED" .490.49.
<br /> ---_................__„,,.,,,,,,,,,,,,,,,,ww.-,o®,o„,m,..m,,,,_.................___.._.....__......_.........-. .. ',AIMwCC fir moniafin�oroatnaicd emar rnin_9ntV-(?cr HSC' 232>;,IS.(� 3)..,,.
<br /> 6.SUCTION PIPING MEETS EXEMPTION CRITERIA.[23 CCR 52636(.-.........._.W--- -~
<br /> ❑ 7.NO KE Gl`J TE.....D PIPING PER HEALTH AND SAFETY CODE,DIVISI ,,.,.,TR .-_._.0__ �---.,.,,,,,.,.,,.,......---.._..._....
<br /> A
<br /> ON 200,CHAPTEER 6.715 CONNECTED TO THE TANK SYSTEM. 410-s1.
<br /> ❑
<br /> 99.OTHER(Specify)`- a9aQ.
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<br /> UPCF UST-D(12/2007)-U5 www.unidoeLarg
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