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MW UNIFIED PROGRAM CONSOLIDATED FORMTSW UNDERGROUND STORAGE TANK MONITORING PLAN-(Pse 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(.';)- 1. FACILITY INFORMATION FACILITY ID#(Agency Use Only) - - 1 BUSINESS NAME(Same as FACILITY NAME) 3. BUSINESS SITE ADDRESS �i / 1 CITY 164 H.EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE 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,w�-1 ,er is more frequent,and that such work must be performed by qualified personnel. 23 CCR 2632 2634 2638 264 1) MONITORING EQUIPMENT IS SERVICED I.ANNUALLY ❑ 99.OTHER S i 0-9-3e ( 1��')' 490-36 III.MONITORING LOCATIONS ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 2634)4904 IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490-5 VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) SECONDARY CONTAINMENT IS: X a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490'6 PANEL MANUFACTURER: L 411. MODEL '-L350 4904 LEAK SENSOR MANUFACTURER: Le 49044 1 MODEL#(S): `10C? 49010 El 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 490-11 PANEL MANUFACTURER: 490-IZ MODEL#: 490-13 IN-TANK PROBE MANUFAC 490.14. MODEL#(S): 490-15 LEAK TEST FREQUENCY: IONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490-16 ❑ d.MONTHLY ❑ e.OTHER(Specify): 49017 PROGRAMMED TESTS: ❑ a.0.1 h. 49014 g.p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): 49019 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490-20 ❑ 4.WEEKLY MANUAL T, =AUGING(MTG)(23 CCR§2645). TESTING PERIOD: [:] a.36 HOURS [Ib.60 HOURS 490-21 49422 ❑ 5.TANK INTEGRITw w'v----•;(23 CCR§2643.1): 490.23 TEST FREQUENCY INUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): 490-24 49025 ❑ 99.OTHER (Specify): 490-26 490-27 V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) I OL1.CONTINUOUS MONITORING OF P` i SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490.24 VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS: a.DRY ❑b.LIQUIDFILLED [3c.PRESSURIZED ❑d.UNDER VACUUM 490-29 PANEL MANUFACTURER: 490.30 MODEL#: -", 49031 LEAK SENSOR MANUFACTURER: 49032 1 MODEL#(S): 49033 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. a. S [Ib.NO 490-34 FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. a.YES ❑b.NO 49035 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 DETECTED 23 CCR 26 490-36 MLLD MANUFACTURER(S): *4 ly- , 490-37 MODEL#(S): L 49034 ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490-39 ELLD MANUFACTURER(S) 49 ' I MODEL#(S): 49041 PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. 490.42 ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490-43 ELLD FAILURE/DISCONNECTION TRIG=FIIO --OMATIC PUMP S-iUTDOWN. ❑a.YES ❑b.NO 49044 ❑ 4.PIPE INTEGRITY TESTING 49o-45 TEST FREQUENCY a.ANNUALLY :VERY 3 YEARS 0 c.OTHERS if 490.46490-47 ❑ 5.VISUAL PIPE MONITORING. 49044 FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 490-49 .Allowed for monitoring of unburied amergewy gamwm fuel piping only HSC 25281.5(6 3) ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(ax3)1. 49050 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490.51 490.52 ❑ 99.OTHER(Specify) 49053 UPCF UST-D(12/2007)1/4