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R UNDERGROUND STORAGE TANK MONITORING PLAN - PAGE I TYPE OF ACTION ❑ I. NEW PLAN ® 2. CHANGE OF INFORMATION M(11. PLAN TYPE ® MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. M02. (Check one item only) ❑ THIS PLAN COVERS ONLY THE FOLLOWING USTSYSTEM(S): I. FACILITY INFORMATION FACILITY ID # (Agency Use Only) - - BUSINESS NAME (Same as FACILITY NAME) AT&T Corp. - CAK482 M03 BUSINESS SITE ADDRESS J -I 10 West Turner Road M04, CITY Lodi Mos. II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE State law requires that testing, preventive maintenance and calibration of monitoring equipment (e,g., sensors, probes, line leak detectors, etc.) 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. MONITORING EQUIPMENT IS SERVICED ® 1. ANNUALLY Moe. ❑ 99. OTHER (Specify): Mal III. MONITORING LOCATIONS 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 ofeach sensor, line leak detector, monitoring system control panel, etc.). Ifyou already have a diagram (e.g., current UST Monitoring Site Plan from a Monitoring System Certification form, Hazardous Materials Business Plan map, etc.) which shows all required information, include it with this plan. IV. TANK MONITORING MONITORING IS PERFORMED USING'THE FOLLOWING METHOD(S): (Check all that apply) ntlo. ® 1. CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR (INTERSTITIAL) SPACE(S) OR SECONDARY CONTAINMENT VAULT(S) SECONDARY CONTAINMENT IS: ® a. DRY ❑ b. LIQUID FILLED ❑ c. PRESSURIZED ❑ d. VACUUM MI 1. PANEL MANUFACTURER: Veeder-Root M12. MODEL #: TLS -350 Plus M13. LEAK SENSOR MANUFACTURER: Veeder-Root M14. MODEL #(S): 794380-420 MI5. ❑ 2. AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SINGLE WALL TANK(S) PANEL MANUFACTURER. M1e MODEL #: M17 IN -TANK PROBE MANUFACTURER: Mlx. MODEL #(S): M1v. LEAK TEST FREQUENCY: ❑ a. CONTINUOUS ❑ b. DAILY/NIGHTLY ❑ c. WEEKLY M20. ❑ d. MONTHLYM21 ❑ e. OTHER (Specify): (�P S eci M22. M23 PROGRAMMED TESTS: ❑ a. 0.1 g.p.h. ❑ b. 02 g.p.h. ❑ c. OTHERfY) ❑ 3. INVENTORY RECONCILIATION ❑ a. MANUAL PER 23 CCR §2646 ❑ b. STATISTICAL PER 23 CCR §2646.1 M24 ❑ 4. WEEKLY MANUAL TANK GAUGING (MTG) PER 23 CCR §2645 TESTING PERIOD: ❑ a. 36 HOURS ❑ b. 60 HOURS Mzs ❑ 5. INTEGRITY TESTING PER 23 CCR §2643.1 Mza Mn TEST FREQUENCY: [:]a. ANNUALLY Elb. BIENNIALLY ❑ c. OTHER (Specify): ❑ 6.VISUAL MONITORING DONE: ❑ a. DAILY ❑ b. WEEKLY (Requires agency approval) ❑ 99. OTHER (Specify): M2x. V. PIPE MONITORING MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) M30 ® 1. CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(S)/TRENCH(ES) AND OTHER SECONDARY CONTAINMENT SECONDARY CONTAINMENT IS: ® a. DRY [Ib. LIQUID FILLED ❑ c. PRESSURIZED ❑ d. VACUUM M31 PANEL MANUFACTURER: Veeder-Root M32.MODEL #: TLS -350 Pius Mai LEAK SENSOR MANUFACTURER: Veeder-Root M34. MODEL #(S): 794380-208 M35. WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP (i.e., TURBINE) SHUTDOWN? ❑ a. YES ® b. NO Mia, WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a. YES ® b. NO M37. ❑ 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 Max. M3v MILD MANUFACTURER(s): MODEL #(S): ❑ 3. ELECTRONIC LINE LEAK DETECTOR (ELLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS ELLD MANUFACTURER: M40 MODEL #: M41. g P� g.p.h. PROGRAMMED IN LINE TESTING: ❑ a. MINIMUM MONTHLY 0.2h. ❑ b. MINIMUM ANNUAL 0.1 h. M42. WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP Si-iUTDOWN? ❑ a. YES ❑ b. NO M43. WILL ELLD FAILURE/DISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ❑ a. YES ❑ b. NO M44 ❑ 4. INTEGRITY TESTING TEST FREQUENCY: ❑ a. ANNUALLY ❑ b. EVERY 3 YEARS ❑ c. OTHER (Specify) M45 Mon ❑ 5.VISUAL MONITORING DONE: ❑ a. DAILY ❑ b. WEEKLY" ❑ C. MIN. MONTHLY & EACH TIME SYSTEM OPERATED- M47 - Requires ageney approval '• Allowed for mommmrg of unburied emergency generator fuel piping only per HSC §25281.5(b)(3) ❑ 6. SUCTION PIPING MEETS EXEMPTION CRITERIA PER 23 CCR §2636(a)(3) ❑ 7. NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) M4x. ❑ 99 OTHER (Specify) hwfwre-d (9/24/04) - 2/4