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NIFIED PROGRAM CONSOLIDATED FO UNDERGROUND STORAGE TANK MONITORING PLAN- Page I of 2) TYPE OF ACTION MI.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(S)- L AGILITY INFOR.MATIUN FACILITY ID#(Agency Use Only) I I Ia - 1 BUSINESS NAME(Same as FACILITY NAME) 3 BUSINESS SITE ADDRESS Zs�s ► `f / 103. CITY �o c '22,� 104. H.EQUIPMENT TE$ONG 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,whichever is more frequent,and that such work must be performed by qualified personnel. (23 CCR§2632,2634,2638,2641) -1.ANNUALLY 490-3a MONITORING EQUIPMENT IS SERVICED 99.OTER( ecify): 490-3b III:MONITORING LOCATIONS ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. ❑2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, 2634)49o4 IV.TANK I IOl 1I O T+G,IS RI(}Ii111 D USING TTIE FOLLO ING THOD( }: 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: a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490-6 - - - -- - - - - --------------------------------- - - ---------- 490-7. 490-8 PANEL MANUFACTURER: T MODEL#: (.S -- ------- - - --- -------- -- -- - - ------- ---1- -- -L#- -- - - - - - -/-, - - - - - LEAK SENSOR MANUFACTURER: (,� W ago 9. 1 MODEL#(S): 7 7 490-,0 ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 90-I I PANEL MANUFACTURER: 490-12. MODEL#: 490-13 --- - -------- - - - ----------------------------------------------------------- ----------- -- -- - - - - - -- - - - ------------------------------------------- IN-TANK PROBE MANUFACTURER: 490-14. MODEL#(S): 490-15 - - - - - ----------------------------------- - ----------------------------- - -- - - - - -- - - -- - - - - - - - - - -- - - - -- --------------- - - - - - - - LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490-16 ❑ d.MONTHLY El e.OTHER(Specify): 490-17 . --------------------------------------- - -- - ------- --- --------- --- --------- --------- ------- -------- ------ PROGRAMMED TESTS: ❑ a.0.1 h. ❑ b.0.2 h. ❑ c.OTHER490-18 g�P� g�P• (Specify): a9oa9 ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490-20 ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: Ela.36 HOURS Elb.60 HOURS 4 90-21 F5.TANK INTEGRITY TESTING(23 CCR§2643.1): a9o- TEST FREQUENCY: a.ANNUALLY Elb.BIENNIALLY Elc.OTHERS eci 90-2a ( p �)' 490-25 ❑99.OTHER (Specify): 490-26 490-27 V.PIPE-MUNITORINQ;I PER*bAMt ?USING tHE FOLLOWING METHODS)(Check all that ioPlY) 19 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-28 VISUAL ALARMS. (23 CCR§2636) SECONDARY CONTAINMENT IS:M...DRY ❑b.LIQUID FILLED ❑c.PRESSURIZED ❑d.UNDER VACUUM 490-29 ----------------------------------y-- -am------------�----------------y-g-N---'-- - -----------49-0--3 -0 --- - ---------------L----------- - -- - - 490-31 PANEL MANUFACTURER - MODEL#: - _ LEAK SENSOR_MANUFACTURER: �i+ �- -49032 L MODEL#(S)_ 490 33 PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. Ka.YES ❑b.NO 490-34 FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. t9a.YES ❑b.NO 490-35 ❑ 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 2636 490-36 MLLD MANUFACTURER(S): 490-37 MODEL#(S): 490-38 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490-39 ---------------------------- - --- -- - �-------------------490-40 -�------------------- - - --- ELLD MANUFACTURER(S) - ,.�E�- - - )-MODEL#(S)-- - - ---------------------------------------------- PROGRAMMED - - -- - - - - - - - - -® - ---------------- -- PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. 490-42 ELLD D N OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. a.YES ❑b.NO 490-43 ELLD AILD ISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. a.YES ❑b.NO 49044 4.PIPE INTEGRITY TESTING 490-45 TEST FREQUENCY ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 490-46490-47 5.VISUAL PIPE MONITORING. 49048 FREQUENCY N a.DAILY ❑ b.WEEKLY ❑c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 49049 *Allowed for monitorin of unburied emergency enerator fuel piping only per HSC§25281,5(b)(3 ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA[23 CCR§2636(a)(3)1. 490-50 ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM 490-51 E] 99.OTHER(Specify) 490-52 490-53 UPCF UST-D(12/2007)1/4