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BILLING_PRE 2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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DR MARTIN LUTHER KING JR
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2300 - Underground Storage Tank Program
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PR0231055
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BILLING_PRE 2019
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Last modified
3/22/2023 3:04:57 PM
Creation date
11/25/2019 3:53:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0231055
PE
2361
FACILITY_ID
FA0002321
FACILITY_NAME
Delta arco
STREET_NUMBER
440
Direction
W
STREET_NAME
DR MARTIN LUTHER KING JR
STREET_TYPE
BLVD
City
STOCKTON
Zip
95206
APN
16503003
CURRENT_STATUS
01
SITE_LOCATION
440 W DR MARTIN LUTHER KING JR BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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1Am <br /> UNIFIED PROGRAM CONSOLIDATED FWLW <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN (Page 2 of 2) <br /> VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING <br /> 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-548 <br /> 1.CONTINUOUS ELECTRONIC MONITORING 112.FLOAT AND CHAIN ASSEMBLY 113.ELECTRONIC STAND-ALONE 490.546 <br /> ❑ 4.NO DISPENSERS 1199.OTHER(Specify): <br /> PANEL MANUFACTURER: t t�(_Y% 490'55 MODEL#: I,V,, C: 49456 <br /> LEAK SENSOR MANUFACTURER: it• 490-57 1 MODEL#(S): vSs 49459 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ®-eYES ❑b.NO 490'59 <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN &T YES ❑b.NO 490.60. <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. Old.YES ❑b.NO 490.61 <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER ❑AYES ❑b.NO 49462 <br /> 2.UDC CONSTRUCTION IS SINGLE-WALLED 112.DOUBLE-WALLED 490-63 <br /> IF DOUBLE WALLED: 490-64a <br /> UDC INTERSTITIAL SPACE IS MONITORED BY: El 1.LIQUID Q 2.PRESSURE 0 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 49465. <br /> L D TECTION(ELD)MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED. 23 CCR 2644.1 <br /> @2, CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490'66 <br /> SPILL BUCKETS ARE TESTED ANNUALLY. 49467 <br /> VIII.RECORDKEEPING <br /> Th„a fallowing monitoring/maintenance records are kept for this facility: <br /> Alarm logs 490-69a ❑Visual Inspection Records 490.68b ❑Tank integrity testing results 490.69 <br /> ❑SIR testing results(and supporting documentation records). 490-69d ❑ Tank gauging results(and supporting documentation records). 490.6U <br /> [] Testing results(and supporting documentation records).490-69f ❑ Corrosion Protection 60-day logs 494696 <br /> Equipment maintenance and calibration records. 490.69h <br /> IX.TRAINING <br /> EiTersonnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 49469a <br /> REFLWNCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) <br /> [7JHIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490-69b <br /> OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)490-696 <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490.69d <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 49469e <br /> ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND <br /> STATISTICAL INVENTORY RECONCILIATION"490-69f <br /> ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"494696 <br /> OTHER(Specify):M69h,M69i <br /> 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.49470 <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.49471 <br /> (�SLL PuLEs(A_, = �) LAPI?,2A 0L. -k 3� >� <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 responsib-for performing the monitoring and equipment maintenance: <br /> NAME AU�'� �j i s C 4942 TITLE (:> 49473 <br /> NAME 49474 TITLE 49475 <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 49476 DATE: 490-77 <br /> APPLICANT NAME(print): 6 �D --!�AAJ CH <br /> 490'78 APPLICANT TITLE: ` , � 490-79 <br /> UPCF UST-D(12/2007)3/4 Vv y <br /> LA <br />
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