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AIL . IFIED PROGRAM CONSOLIDATED UNDERGROUND STORAGE TANK MONITORING PLAN - (Page I of 2) ENVIRONMENT HEALTH 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(S): I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) 17� I II BUSINESS NAME(Same as Facility Name or DBA) FLYING J TRAVEL PLAZA 3. BUSINESS SITE ADDRESS 15237 THORNTON ROAD 103 CITY LODI 104 IL 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 b the equipment manufacturers'instructions,or annually,whichever is more frequent.Such work must be performed b ualified personnel.[23 CCR.§2632,2634,2638,2641.] ...................................................... ......__..........................Y...9........................... ................................................... Y...............e9......I�........._..._..__............................................................................_..............................................Y.................._..................................................... ............................... MONITORING EQUIPMENT IS SERVICED ® 1.ANNUALLY ❑ 99.OTHER(Specify): 490-3b. IIIc ,MONITORING LOCATIONS ❑ 1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN ® 2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED [23 CCR§2632,26341 490-4. IV. TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S);, ;ai k ® 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT VAULT(S) 490-5. WITH AUDIBLE AND VISUAL ALARMS.[23 CCR§2632,26341 SECONDARY CONTAINMENT IS: ® a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑ d.UNDER VACUUM 490-6. PANEL MANUFACTURER: VEEDER-ROOT/OMNTEC 490-7 MODEL#: TLS-350/800011 490-1. LEAK SENSOR MANUFACTURER: VEEDER-ROOT 490-9. MODEL#(s): 303 490-10. -............................._... ........_._._..._._......_ .._............---................ _..__.._. .............................. ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL 7f §i.[23 CCR§2643] 490-11. 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 ❑ e.OTHER(Specify): 490-17. PROGRAMMED TESTS: ❑ a.0.1 h. ❑ b.0.2 h. ❑ c.OTHER(Specify). ago-]s. ......................................................................._..............................._.....................................__.._.._�_..._................._g g.p.h. ......._a9o-t9. ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION[23 CCR§2646.1] 490-20. .... . ............................................................................................................................._............................................................._......_................................................................................. ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)[z3 CCR§z6as1 TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS 490-21. 490-22. ❑ 5.TANK INTEGRITY TESTING PER[23 CCR§2643.1] 490-23. TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.BIENNIALLY ❑ c.OTHER(Specify): ago 24. Q ( P fi') a..... ® 99.OTHER(specify): VISUAL DONE DAILY 490-26. 490.27. V. PIPE MO O GIS fERFO D USING FOI:I O G'METHOD(S) (Qaeckgtl, ® 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE&VISUAL ALARMS. 490-21• [23 CCR SECONDARY CONTAINMENT IS: ® a.DRY [3b.LIQUID FILLED El c.PRESSURIZED ❑ d.UNDER VACUUM 490-29. §2636PANEL MANUFACTURER:VEEDER-ROOT/OMNTEC 490-30. MODEL#: TLS-350/800011 490-31. LEAK SENSOR MANUFACTURER: VEEDER-ROOT 490-32. MODEL#(S): 322 490-33. PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ® a.YES ❑ b.NO 490-34. FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a.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 490-36. PRODUCT FLOW WHEN A LEAK IS DETECTED.[23 CCR§26361 MLLD MANUFACTURER(S):FE PETRO 490-37. MODEL#(S): MLD 490-38. ........................................................................................----.................................._...._. ...._._........................................._................._........._ ...................... ( ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD) THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS.[23 CCR§26361 490-39. ELLD MANUFACTURER(S): 490-40. MODEL#(S): 490-41. PROGRAMMED IN LINE LEAK TEST: ❑ a.MINIMUM MONTHLY 0.2 g.p.h. ❑ b.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 TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑ b.NO 490-44. ..............................................................................................................................................................................................................................................................._........ ® 4.PIPE INTEGRITY TESTING. 490-45. TEST FREQUENCY: ❑ a.ANNUALLY ❑ b.EVERY 3 YEARS ® c.OTHER(Specify) N/A D/T OS.Shutdow11 490-47. ..................................................-...............................................................................................__....._._._.._...................__.._....._._...................................................................................................................................................................................................................... ..............490.48..... ❑ 5.VISUAL PIPE MONITORING. FREQUENCY: ❑ a.DAILY ❑ b.WEEKLY ❑ C.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 490-49. ._......_..... ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA.[23 CCR§2636(a)(3)] 490-50. ......................_......_...._............_................................................................................................................................................................................................................................................................._...._.._..........._......_............................................................................................................................................................................................................._.._.__....._ ❑ 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM. 490-51. ❑ .................................................................................................._..........................._..............................................................--.........................................................................................................................................................._..............................._.._................................................................................................................................................................4 . . .._............_99.OTHER(Specify) 90-52. 490-53. 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