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UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN- Page I of 2) <br /> TYPE OF ACTION ❑ 1.NEW PLAN 0 2.CHANGE OF INFORMATION 490-1 <br /> PLAN TYPE Z 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490-2 <br /> (Check one item only) El 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(): <br /> ILY-'�': <br /> "'M <br /> FACILITY ID#(Agency Use Only) <br /> BUSINESS NAME(Same as FACILITY NAME) Tracy Blvd.Shell # 136186 3. <br /> BUSINESS SITE ADDRESS 3725 N.Tracy Boulevard 103- CITY Tracy 104. <br /> 1EQUIPMENT 0St*,*iAN6,P' A <br /> Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must be performed at the frequency <br /> specified by the equipment manufacturers'instructions,or annually,whichever is more frequent,and that such work must be performed by qualified personnel, <br /> (23CCR§2632,2634,2638,2641) ------------ <br /> MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY El 99.OTHER(Specify): 490-3490-3ab <br /> V-� <br /> 10i )$ " r . hIkI - T 1-1 1 -,J <br /> I", - NO ,`- <br /> [3 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. IM 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, <br /> 2634 4904 <br /> 4 x", <br /> k <br /> 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490-5 <br /> VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) <br /> SECONDARY CONTAINMENT IS: [3 a.DRY ED b.LIQUID FILLED El c.PRESSURIZED [I d.UNDER VACUUM 490-6 <br /> --------------------- <br /> PANEL MANUFACTURER: Veeder Root 0.9"- 1 MODEL#: TLS-350R 490-8 <br /> -------j <br /> LEAK SENSOR MANUFACTURER: Veeder Root 490-9. 794380-301 490-10 <br /> El 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 490-11 <br /> PANEL MANUFACTURER: 490-11, MODEL#: 490-13 <br /> ----------------------------- --------------------------------- <br /> -- <br /> IN-TANK PROBE MANUFACTURER: 490-14. MODEL#(S): 490-15 <br /> LEAK TEST FREQUENCY: 0 a.CONTINUOUS [:1 b.DAILY/NIGHTLY ❑ c.WEEKLY 490-16 <br /> [I d.MONTHLY El e.OTHER(Specify): 490-17 <br /> 490-18 <br /> PROGRAMMED TESTS: El a.0.1 g.p.h. ❑C1 b.0.2 g.p.h. c.OTHER(Specify): 490-19 <br /> ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490-20 <br /> ❑ 490-21 <br /> 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: Ej a.36HOURS [Ib.60 HOURS 490-22 <br /> ❑ 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 <br /> TEST FREUENCY: ❑El a.ANNUALLY El b.BIENNIALLY El c.OTHER( p <br /> Secify490-24 <br /> Q): 490-25 <br /> 99.OTHER (specify): Simplicity 490-27 <br /> V PIPE MONIT®RING IS PERFORMED q THk F0L0*1N' Q"METHODS) <br /> kQ <br /> ED 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-28 <br /> VISUAL ALARMS. (23 CCR§2636) <br /> -------- <br /> SECONDARYCONTAINMENTIS:Za.DRY Ob.LIQUID FILLED [:Ic.PRESSURIZED Eld.UNDER VACUUM 490-29 <br /> PANEL MANUFACTURER: Veeder Root 490-30 MODEL#: --TLS-350R 490-31 <br /> LEAK SENSOR MANUFACTURER: Veeder Root 490-32 MODEL#(s): 794380-208 490-33 <br /> PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. Z a.YES El b.NO 490-34 <br /> FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ED a.YES 0 b.NO 490-35 <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(23 CCR§2636) 490-36 <br /> ------------- <br /> MLLD MANUFACTURER(S): -4,90-iT--MODEL 490-38 <br /> Z 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490-39 <br /> •--------- - ----- --- - - --__- _ __ <br /> ELL <br /> --------- <br /> ELLD MANUFACTURER(S) Veeder Root 41111. 1 MODEL#(S): 8484 49041 <br /> ------------------ -- -- ____ _---_---- --- -------- - - ------ ------- ----- <br /> PROGRAMME <br /> ---------------- <br /> PROGRAMMED IN LINE LEAK TEST: F-1 1.MINIMUM MONTHLY 0.2 g.p.h. El 2.MINIMUM ANNUAL 0.1 g.p.h. 490-42 <br /> ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. El a.YES El b.NO 49043 <br /> ELLD FAILURE/iDISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. 191 a.YES El b.NO 49044 <br /> El 4.PIPE INTEGRITY TESTING 49045 <br /> TEST FREQUENCY El a.ANNUALLY 0 b.EVERY 3 YEARS El c.OTHER(Specify) 4904649047 <br /> 0 5.VISUAL PIPE MONITORING. 49048 <br /> FREQUENCY El a.DAILY El b.WEEKLY El c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 490-49 <br /> *Allowed for monitoring of unburied emergency generator fuel piping only per HSC§25281.5(b)(3) <br /> ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(a)(3)1. 490-50 <br /> 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM <br /> 490-51 <br /> ❑ 99.OTHER(Specify) 490-52490-53 <br /> UPCF UST-D(12/2007)1/5 <br />