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BILLING_PRE 2019
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2300 - Underground Storage Tank Program
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PR0537549
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BILLING_PRE 2019
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Entry Properties
Last modified
4/28/2021 4:52:46 PM
Creation date
11/5/2018 1:04:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0537549
PE
2351
FACILITY_ID
FA0021617
FACILITY_NAME
HARNEY LANE AMPM
STREET_NUMBER
255
Direction
E
STREET_NAME
HARNEY
STREET_TYPE
Ln
City
Lodi
Zip
95240
APN
062-580-40
CURRENT_STATUS
01
SITE_LOCATION
255 E Harney Ln
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\H\HARNEY\255\PR0537549\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
7/18/2017 11:36:57 PM
QuestysRecordID
3515379
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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UNIFIED PROGR%Nl CONSOUIDATED FORM <br /> I INDERGROU ND S"FOR W&TANK <br /> NioNit-ORINGPLAS (Pagf2ofZ1 <br /> V1.UNDER DISPENSER CONTAINMENT(UDC.)MONITORING <br /> FI— FOLLOWINGMEIHOI) <br /> 1. UDC NION FLOWING IS PERFORMED TRI:F— 4Ws* <br /> i.CONTINUOUS ELECTRONIC M(.)Nll()PIWI [31FLOAT ANDCHAINASSEMIUY 0 3,11-FCTRONICSTAND-ALONE <br /> PANEL mANuFAcTuRFR:Veeder-Root TLS-350 <br /> LEAK SENSOR MANOFACTMER Veeder-Root moDELLi(s). 794380-208 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS E & YES Ob.NO <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN 0 a YLS 0 Is NO <br /> FAJLURU IDISCONNECTION OF UDC MoNIrMINGSYSTEM TOU(tGMAUTOMATIC PtJMPSII(nDWN. MaYES Ob-NO OW <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AI TOP DISPENSER. a Y" ❑b.No <br /> 2.UDC CONSTRUCTION IS 0 1 SINQLF,-WAI1A-M 02.DDURLE-WALLED <br /> IF DOUBLE Ni,ALLED. <br /> ITX INTERS1111AL SPACE IS MONITUREDBY, pjjj%tL1D_a2 .1 - 3 V6�C <br /> --- -------- <br /> A L+Als W LHIN THE "CONDARY CONTAINMENTO F TIM UDC TRIGGERS AUDIBLE AND VISUAL ALARMS w a Yf.S 0 b NO <br /> 0 1 FILL TF-STING fWfKFWHM HAS BEEN NOTIFIED BY THE STATE' WATER RESOURCES CON FROL BOARD TTHAT LW�l <br /> EEO I$PERFORMED EVERY 36 MON FUS AS RE.QU XR-13—iL <br /> ❑2.SECONDAR)'CONTAMMENT COMPONENTS ARE TESTED EVERY 36 MONTHS <br /> ------------------- <br /> 3—SPICLIMUCKITS&BY TESTED ANNUALLY <br /> VM.RECORIMEPING <br /> the folowaig; mcordsom,kept far this facflrtY' <br /> Alan,logs '" iu Visual fraipwtuna Rrawds 4w Tank oulogrov testing results <br /> 0 SIR testing results(and suppming 44"m ❑ Leak gauging Malt%(and SUPpOinagaincsinnanagantl ansudi) 4W"aa <br /> 0 ATC,Testing Mulls land Supp sting ducumontalft*mcolds) Awse' 0 Coircuatin Pro acrun,5ti-da}kin,a Wx, <br /> UL TRAINING <br /> Parsannci w rth U51 msmrurreng rtapmkR+ihics arc familiar will all oftla:folbxtin$documents rtlesant in fico 1nh doses 4saws, <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check W1 IhWapp4) <br /> FRIS UNDERGROUND STORAGE TANK MMITORING PLAN(Roxlurmd)*w+�ass <br /> OFFRATING MANUALS FOR ELECTRONIC MONITORING UQUIPMENT(Rrquvrvd),,sn . <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS44"sit <br /> ❑ CALIFORNIA UNDERGROUND,STORAGE TANK LAW 4004% <br /> STATE WATER RESOURCES CONTROL BOARD (SWRCILF PUBLICATION: -HANDBOOK FOR TANK 0'%7*,RS MANUAL AND <br /> STATISTICAL INVENTORY KFCGNCU.lATkGN"*Wso( <br /> 1 E3 SNIoRCH PUBLICATION "tNDFRSTAKDTKIDAUTOMATIC TANK GAUGING SYSTEMS"4404ft <br /> ❑ OTHER(SPWiN) WW slas <br /> This facility has a`Dnignakd LIST Opetalor-wN has passed the California UST System Opetatiar Exam vibrarimicted by the Irninnsitansal Codecourictl(R'C) <br /> `Dasigtsmed UST Gator" ill vass facility employees in 0w proper kipasation and rnaimeatanex of the UST gitstcris annually.and within 30 dava of him rhes � <br /> training will include,but at ran limited to,the liallowng <br /> Oporglasnofthe UST systems inairstantsr cssFksictenl xnh the f1wilay's beat tranawnicat prudes <br /> I <br /> The hict[it,employee's role with regard to the nisautcuing equipment as specified in this US I Monitoring Plan <br /> lbr twit ny cmplatvc's rule with regard to gn 11%and averfiff,as spm ified ill the UST Riespratac Plan <br /> Names of contact person(s)an emergencies and arantooting alarms laws <br /> X. CO?NINENT3fADDITIONAL INFORMATION <br /> Pros Ido additional continents hem in vsdic4de h0w,man}pages with additional itilbsination on specific vast act ing:procedua,art attached to this Plan 4w.7, <br /> XL PERSONNEL RESPONSIBILITIES <br /> The UST Clsstner"Makis lues and maintenance oFUST leak detection equituncrit cosvwd hs <br /> this plan occurs,2)all Conditions that indicate a possible rclfta we oroviisitgaval,and 3)all noun sig rcoxdF we maintained paspclly <br /> The folkissing possorm s)we responsible Its pet-flutwag the numattrienrig and equalurient nutwunitnor I <br /> NAME sues,- TITLF W-71 <br /> NAME ~4 JITLF "i'TA <br /> The Designated Op"Mor shall perform 4 monthly its") inspecum of the facility. painade a rcpcol to the and infunnit the ownevopwatur W--71 <br /> XII.OWNER/OPERATOR SIGNATURE <br /> CE-1131FICA TION:I Amutatt to the beat ofiny knarw <br /> APPLICANT STEiRE 4a'N' DATEr <br /> i i013 I % L� <br /> I A <br /> APPLICANT NAW,4pnall A VPf,X'A N I I I 11.1, <br /> FPCF VST-D(I M007)314 <br />
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