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SAN JOAQUJIFOUNTY ENVIRONMENTAL HEALTHMOARTMENT <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN -PAGE I <br /> M01 <br /> TYPE OF ACTION , <br /> I.NEW PLAN ❑ 2.CHANGE OF INFORMATION <br /> MO?, <br /> PLAN TYPE ❑ MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. <br /> (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): _ <br /> I. FACILITY INFORMATION <br /> [FACILITY ID#(Agency Use Onl}•) - - <br /> MO3. <br /> ILITY NAMEgaAU ILITY SITE ADDRESS fit/ �o teo <br /> M04. CITY �JL`�-44,-•c, Mos. <br /> II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE <br /> State law requires that testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)be performed in Mob, <br /> accordance with the equipment manufacturers'instructions,or annually,whichever is more frequent. Such work must be performed by qualified personnel. M07 <br /> MONITORING EQUIPMENT IS SERVICED 6 1.ANNUALLY ❑ 99.OTHER(Specify): <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 /> M10. <br /> MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S):(Check all that apply) <br /> �} 1.CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) <br /> SECONDARY CONTAINMENT IS: a.DRY ❑ b.LIQUID FILLED ❑ c.UNDER PRESSURE ❑ d.UNDER VACUUM <br /> MI I. <br /> P <br /> PANEL MANUFACTURER: t/ v'vy, <br /> lr Mlz. MODEL#: ^1 �- <i 13 I!= MEA <br /> r ��7 <br /> LEAK SENSOR MANUFACTURER: le M14. MODEL#(S): �� D�� j mns. <br /> ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S) <br /> M16. MODEL#: M1 <br /> 7. <br /> PANEL MANUFACTURER: <br /> MIA. MODEL.#(S): M9 <br /> 19. <br /> IN-TANK PROBE MANUFACTURER: <br /> LEAK TEST FREQUENCY: ❑ a.CONTINUOUS [:1b.DAILYINIGHTLY ❑ c.WEEKLY M21 <br /> e.OTHER(Specify): M21 <br /> ❑ d.MONTHLY [Ip Y)� <br /> M2'_ M23. <br /> PROGRAMMED TESTS: 11a.0.1 g.p.h. El b.0.2 g.p.h. El c.OTHER(Specify): <br /> ❑ M?4. <br /> 3.INVENTORY RECONCILIATION [Ia.MANUAL PER 23 CCR§2646 ❑ b.STATISTICAL PER 23 CCR§2646.1 <br /> ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)PER 23 CCR§2645 <br /> TESTING PERIOD: ❑ a.36 HOURS El b.60 HOURS Mzs. <br /> ❑ 5.INTEGRITY TESTING PER 23 CCR§2643.1 Mz6 M2T <br /> TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): <br /> ❑ 6.VISUAL MONITORING DONE: 'ga.DAILY ❑ b.WEEKLY(Requires agency approval) <br /> M28. <br /> ❑ 99.OTHER(Specify): <br /> V. PIPE MONITORING <br /> M30, <br /> MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) <br /> 1.CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(S)/TRENCH(ES)AND OTHER SECONDARY CONTAINMENT <br /> SECONDARY CONTAINMENT IS: a.DRY El b.LIQUID FILLED ❑ c.UNDER PRESSURE E] d.UNDER VACUUM M31. <br /> PANEL MANUFACTURER: �/e1 e�pY s��' M32. MODEL#: '7 c ' 3�Z M33. <br /> M34. MODEL#(S): �jj(J-- 2' M35. <br /> LEAK SENSOR MANUFACTURER: f/ �� <br /> WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN? ,'9-a.YES E] b.NO M36 <br /> WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? 6-a.YES ❑ b.NO <br /> 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 �� M39 <br /> MLLD MANUFACTURER(s): %1 Pz S y. e,5 Mag. MODEL#(S): .�rD /Z- <br /> ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS <br /> Mao. MODEL#: M41. <br /> ELLD MANUFACTURER: <br /> M1t4z. <br /> PROGRAMMED LINE INTEGRITY TESTS: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.MINIMUM ANNUAL 0.1 g.p.h. <br /> Mai. <br /> WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a.YES Elb.NO <br /> WILL ELLD FAILURE/DISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN. ❑ <br /> a.YES ❑ b.NO Mao. <br /> ❑ 4.INTEGRITY TESTING M45. M46, <br /> TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS El c.OILIER(Specify) <br /> ❑ <br /> S.VISUAL MONITORING DONE: a.DAILY ❑ b.WEEKLY* ❑ c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED" WT <br /> 'Requires agency approval "•Allowed for monitoring of unburied emergency generator fuel piping only per HSC§25251.5(6)(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) M48 <br /> ❑ <br /> 99.OTHER(Specify) <br /> 07/23/03 <br /> SJCEHD-d(07/03)-1/4 <br />