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BILLING_PRE 2019
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231223
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BILLING_PRE 2019
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Last modified
12/16/2019 4:25:53 PM
Creation date
12/16/2019 3:24:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0231223
PE
2361
FACILITY_ID
FA0002324
FACILITY_NAME
Pacific Service Station
STREET_NUMBER
6131
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
09746418
CURRENT_STATUS
01
SITE_LOCATION
6131 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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ARL <br /> I_.r FIED PROGRAM CONSOLIDATED FOR!F. <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN - (Page 2 of 2) <br /> VI. UNDER DISPENSER CONTAINMENT UDC MONITORING Check al <br /> hat apply <br /> UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) <br /> ❑ 1.CONTINUOUS ELECTRONIC MONITORING ® 2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 490-54a. <br /> ❑ 4.NO DISPENSERS ❑ 99.OTHER(Specify) 490-54b. <br /> LEAK MONITOR MANUFACTURER:Bravo 490-55. MODEL#: -79-756. <br /> LEAK SENSOR MANUFACTURER: 490-57. MODEL#(S): 49o-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 C3 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 /> .... _ ._.................. __._..___�__..._.._._ _ _ _........._._�_ <br /> UDC CONSTRUCTION IS: ® 1.SINGLE WALL ❑ 2.DOUBLE WALL 490-63. <br /> IF DOUBLE WALL: 490-64a. <br /> UDC INTERSTITIAL SPACE IS MONITORED BY: ❑ a.LIQUID ❑ b.PRESSURE ❑ c.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. ❑ a.YES ❑ b.NO 49°-646. <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 DETE TION ELD 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 /> ® 3.SPILL BUCKETS ARE TESTED ANNUALLY. 490-67. <br /> VIII. RECORD KEEPING <br /> The following monitoring/maintenance records are kept for this facility: 490-6& <br /> ® a.ALARM LOGS ® b.VISUAL INSPECTION RECORDS ® c.TANK INTEGRITY TESTING RESULTS <br /> ❑ d.SIR TESTING RESULTS(and supporting documentation records) ® e.TANK GAUGING RESULTS(and supporting documentation records) <br /> ❑ f.ATG TESTING RESULTS(and supporting documentation records) ❑ g.CORROSION PROTECTION 60-DAY LOGS <br /> �F <br /> ® h.EQUIPMENT MAINTENANCE AND CALIBRATION RECORDS <br /> IX..TRAINING <br /> ® Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties: 490-69a. <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) <br /> ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 490-69b. <br /> ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) 490-69c. <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d. <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 49"9e. <br /> ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND 490-69f. <br /> STATISTICAL INVENTORY RECONCILIATION" <br /> ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 490-69g. <br /> ❑ OTHER(Specify): 490-69h. <br /> 490-69i. <br /> ® This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International Code Council 490-70. <br /> (ICC). The "Designated UST Operator"will train facility employees in the proper operation and maintenance of the UST systems annually,and within 30 <br /> days of hire.This 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 facility's UST Response Plan. <br /> ➢ Name(s)of contact person(s)for emergencies and monitoring alarms. <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. 490-71. <br /> Drop Tubes with Mechanical Flapper Valves are set at 95%. Discriminating sensors . <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 <br /> by this plan occurs;2.1 all conditions that indicate a possible release are investigated;and 1 all monitorin records are maintained properly. <br /> THE FOLLOWING PERSON(S)ARE RESPONSIBLE FOR PERFORMING THE MONITORING AND EQUIPMENT MAINTENANCE: <br /> NAME: Hung Thanh Tran 490-72. TITLE:Owner 490-73. <br /> NAME: 490-74. TITLE: 490-75. <br /> The Designated UST 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 / DATE: 490-77 <br /> 1'/LT Wer (&flq 1 8/24/2009 <br /> REPRESENTING: 1.Tank Owner/0 erator 2.Fa 't caner/0 erator , 3.Authorized Representative of Owner 490-76. <br /> APPLICANT NAME(print): 490-78. APPLICANT]I f I L. 490-79 <br /> Hung Thanh Tran Owner/Operator <br /> UPCF UST-D(12/2007)-3/4 www.unido .org� <br />
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