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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN-PAGE 1 <br /> TYPE OF ACTION ❑ 1.NEW PLAN ❑ 2.CHANGE OF INFORMATION Mol. <br /> PLAN TYPE ❑ MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. y ` M02. <br /> (Check one item only) 0 THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): <br /> I. FACILITY INFORMATION <br /> FACILITY ID#(Agency Use Only) <br /> FACILITY NAME M03. <br /> FACILITY SITE ADDRESS �^ �� Moo' CITY / M05. <br /> i <br /> II. EQUIPMENT TESTING AND PREVENTIVE MAIN EN.4NCE <br /> State law requires that testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)be performed in M06. <br /> accordance with the equipment manufacturers'instructions,or annually,whichever is more frequent. Such work must be performed by qualified personnel. <br /> MONITORING EQUIPMENT IS SERVICED �4 1.ANNUALLY ❑ 99.OTHER(Specify): Mol' <br /> III. MONITORING LOCATIONS <br /> This monitoring plan must include a Site Plan showing the general tank and piping layouts and the-locations where monitoring is performed(i.e.,location of each sensor, <br /> line leak detector,monitoring system control panel,etc.). If you already have a diagram(e.g.,current UST Monitoring Site Plan from a Monitoring System Certification <br /> form,Hazardous Materials Business Plan map,etc.)which shows all required information,include it with this plan. <br /> IV. TANK MONITORING <br /> MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S):(Check all that apply) M10. <br /> 421 1.CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) <br /> rA SECONDARY CONTAINMENT IS: a.DRY ❑ b.LIQUID FILLED ❑ o,UNDER PRESSURE ❑ d.UNDER VACUUM MI 1. <br /> PANEL MANUFACTURER: I Y< /`�t:' Mlz. MODEL#: 7L '- ;O L M13. <br /> LEAK SENSOR MANUFACTURER: / � � / of Mla. MODEL#(S): �� �� f r'f Mls. <br /> ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S) <br /> PANEL MANUFACTURER: M16. MODEL#: MIT <br /> IN-TANK PROBE MANUFACTURER: Mls. MODEL#(S): M19. <br /> LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY M20. <br /> ❑ d.MONTHLY ❑ e.OTHER(Specify): M21. <br /> PROGRAMMED TESTS: ❑ a.0.1 h. ❑ b.0.2 h. ❑ c.OTHER(Specify): M22. M23. <br /> S•P• g.p.h. ( P fY)� <br /> ❑ 3.INVENTORY RECONCILIATION ❑ a.MANUAL PER 23 CCR§2646 ❑ b.STATISTICAL PER 23 CCR§2646.1 M24. <br /> ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)PER 23 CCR§2645 <br /> TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS M25. <br /> ❑ 5.INTEGRITY TESTING PER 23 CCR§2643.1 <br /> TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): M26. M27. <br /> ❑ 6.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(Requires agency approval) <br /> ❑ 99.OTHER(Specify): Meg. <br /> V. PIPE MONITORING <br /> MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) M30. <br /> I.CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(S)/TRENCH(ES)AND OTHER SECONDARY CONTAINMENT <br /> SECONDARY CONTAINMENT IS: A a.DRY ❑ b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM Mat. <br /> PANEL MANUFACTURER: V ,E2E./� r',O JT M31 MODEL#: V -2g® TM33' <br /> LEAK SENSOR MANUFACTURER: 1>t� li'�x_ roi M34. MODEL#(S): _ M35. <br /> WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN? ❑ a.YES ❑ b.NO M36. <br /> WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M37. <br /> ❑ 2.MECHANICAL LINE LEAK DETECTOR (MLLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF <br /> PRODUCT FLOW WHEN A LEAK IS DETECTED <br /> MLLD MANUFACTURER(s): M38. MODEL#(S): M39. <br /> ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS <br /> ELLD MANUFACTURER: 1440. MODEL#: M41. <br /> PROGRAMMED LINE INTEGRITY TESTS: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1g•P•h. M42. <br /> WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M43. <br /> WILL ELLD FAILURE/DISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES ❑ b.NO M44. <br /> ❑ 4.INTEGRITY TESTING <br /> TEST FREQUENCY: ❑ a.ANNUALLY b.EVERY 3 YEARS ❑ c.OTHER(Specify) M45. M46. <br /> ❑ 5.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY* ❑ c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED" Iv147. <br /> *Requires agency approval **Allowed for monitoring of unburied emergency generator fuel piping only per HSC?125281.5(b)(3) <br /> ❑ 6.PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXEMPTION FROM MONITORING PER 23 CCR§2636(a)(3) <br /> ❑ 7.NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) <br /> C399.OTHER(Specify) M48. <br /> SJCEHD-d(07/03)-1/4 07/23/03 <br />