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PR0231136
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BILLING_PRE 2019
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Entry Properties
Last modified
2/26/2024 1:19:00 PM
Creation date
11/5/2018 3:01:01 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0231136
PE
2361
FACILITY_ID
FA0003610
FACILITY_NAME
A&A GAS & FOOD MART
STREET_NUMBER
16
Direction
E
STREET_NAME
HARDING
STREET_TYPE
WAY
City
STOCKTON
Zip
95204
APN
13902001
CURRENT_STATUS
01
SITE_LOCATION
16 E HARDING WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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KBlackwell
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EHD - Public
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1FIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN (Page 2 of 2) <br /> VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING <br /> L. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-54a <br /> 490.546 <br /> ® 1.CONTINUOUS ELECTRONIC MONITORING [12.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE <br /> ❑4.NO DISPENSERS [199.OTHER(Specify): <br /> PANEL MANUFACTURER:VEEDER ROOT 490-55 44ODEL#:794390-299 rL S ,350 490-56. <br /> LEAK SENSOR MANUFACTURERNEEDER ROOT 490-57 ODEL#(S):'70➢4&9@-499 ?q+380-208 490-58 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ® a.YES ❑b.NO 490-59 <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ® a.YES ❑b.NO 490-60 <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a YES ❑b.NO 490-61 <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. ® a.YES ❑b.NO 490-62 <br /> 2.UDC CONSTRUCTION IS ®1.SINGLE-WALLED [12.DOUBLE-WALLED 490-63 <br /> IF DOUBLE WALLED: 490-64a <br /> UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ 1.LIQUID [12.PRESSURE ❑3.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO 490-64b <br /> VII.PERIODIC SYSTEM TESTING <br /> ❑ 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65. <br /> LEAK DETECTIMLWM MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED.(23 CCR§2644.1) <br /> ®2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490-66 <br /> 50 3.SPILL BUCKETS ARE TESTED ANNUALLY. ----- 490-67 <br /> VIII.RECORDKEEPING <br /> The following monitoring/maintenance records are kept for this facility: <br /> ®Alarm logs 490-68a ❑Visual Inspection Records 490.686 ❑Tank integrity testing results 490-68e <br /> ❑SIR testing results(and supporting documentation records). 49-68d ❑ Tank gauging results(and supporting documentation records). 49t}bge <br /> ❑ATG Testing results(and supporting documentation records).490-68f ❑ Corrosion Protection 60-day logs 490-68g <br /> ®Equipment maintenance and calibration records. 490-ah <br /> IX.TRAINING <br /> ®Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 49-69a <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY U <br /> ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)49-696 <br /> ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490-69e <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 4go 69d <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 49o-69e <br /> ® STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND <br /> STATISTICAL INVENTORY RECONCILIATION"490-W <br /> ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"49-696 <br /> ❑ OTHER(Specify):M69h,M69i <br /> ED This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council(ICC). <br /> The"Designated UST Operator"will train facility employees in the proper operation and maintenance of the UST systems annually,and within 30 days of hire.This <br /> training will include,but is not limited to,the following: <br /> ➢ Operation of the UST systems in a manner consistent with the facility's best management practices <br /> ➢ The facility employee's role with regard to the monitoring equipment as specified in this UST Monitoring Plan <br /> The facility employee's role with regard to spills and overfills as specified in the UST Response Plan <br /> ➢ Names of contact person(s)for emergencies and monitoring alarms.49-70 <br /> X. COMMENTS/ADDITIONAL INFORMATION <br /> Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan.49-71 <br /> AU618Li: Y VISV^L 4LARM SET A I 90% OF TANK r—ArACtTy <br /> XI.PERSONNEL RESPONSIBILITIES <br /> The UST Owner/Operator is responsible for ensuring that:1)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment covered by <br /> this plan occurs,2)all conditions that indicate a possible release are investigated,and 3)all monitoring records are maintained properly. <br /> The following person(s)are responsible for performing the monitoring and equipment maintenance: <br /> NAME ABRAHAM CYRUS 490-72 TITLE OWNER <br /> 49-73 <br /> NAME 49-74 TITLE 49-75 <br /> The Designated Operator shall perform a monthly visual inspection of the facility, provide a report to the owner/operator, and inform the owner/operator of any <br /> conditions that need follow-up action. <br /> XII.OWNER/OPERATOR SIGNATURE <br /> CERTIFICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. <br /> APPLICANT SIGNATURE 49-76 DATE: 490-77 <br /> REPRE ENT[N 1.T or 2.Facil Owner/ or 3.Authorized Re reser alive of Owner <br /> APPLICANT NAME(print): 0-e0-78 APPLIC TITLE: 0-90-79 <br /> OWNER <br /> UPCF UST-D(12/2007)3/4 <br />
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