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COMPLIANCE INFO_1997-2012
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2300 - Underground Storage Tank Program
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PR0231333
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COMPLIANCE INFO_1997-2012
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Last modified
9/24/2024 2:31:42 PM
Creation date
6/3/2020 9:46:41 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1997-2012
RECORD_ID
PR0231333
PE
2361
FACILITY_ID
FA0003711
FACILITY_NAME
LAKEWOOD CHEVRON
STREET_NUMBER
236
Direction
N
STREET_NAME
HAM
STREET_TYPE
LN
City
LODI
Zip
95240
APN
03710028
CURRENT_STATUS
01
SITE_LOCATION
236 N HAM LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
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FilePath
\MIGRATIONS\UST\UST_2361_PR0231333_236 N HAM_1997-2012.tif
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EHD - Public
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II ` '/ <br /> ve <br /> t <br /> UNI4 FIED PROGRAM CONSOLIDATED FOR <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN- Page 1 of 2) <br /> TYPE OF ACTION ❑ 1.NEW PLAN ❑ 2.CHANGE OF INFORMATION 490-1 <br /> PLAN TYPE ❑ I.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490-2 <br /> (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S) <br /> I. FACILITY INFORMATION <br /> FACILITY ID#(Agency Use Only) I I I _ I II <br /> BUSINESS NAME(Same as FACILITY NAME) ®N J Affla l 3 <br /> BUSINESS SITE ADDRESS to 1 , _ V.)� 03 CITY 2 a1104 <br /> H.EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE <br /> Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors, probes, line leak detectors,etc.)must be performed at the frequency <br /> specified by the equipment manufacturers'instructions,or annually,whichever is more frequent,and that such work must be performed by qualified personnel. <br /> (23 CCR X2632,2634,2638,2641) <br /> MONITORING EQUIPMENT IS SERVICED I.ANNUALLY El99.OTHER(Specify): 490-30- <br /> 490-36 <br /> III.MONITORING LOCATIONS <br /> ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. ❑2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, <br /> 2634)490-4 <br /> IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): <br /> ❑ 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490-5 <br /> VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) <br /> SECONDARY CONTAINMENT IS: a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490-6 <br /> PANEL MANUFACTURER: MODEL,#: - <br /> 490-8 <br /> ------------------------- ----------------------•------------------------- ------- <br /> --------------� -------------------- <br /> LEAK SENSOR MANUFACTURER: 490-9 1 MODEL#(S): L j c7 490-10 <br /> ❑ 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 490-11 <br /> PANEL MANUFACTURER: -----v- ------T 1-S-----3-5 ----------------- 49a1I-----MODEL#: 490-13 <br /> ------------------------------------------------------- -- ----- <br /> IN-TANK <br /> ---------------------------------------------------------------- <br /> IN-TANK PROBE MANUFACTURER: 490-14. MODEL#(S): 490-15 <br /> ---------------------------------------------------------------------------------------------- <br /> ------------------------ - -- - <br /> LEAK TEST FREQUENCY: 12r-CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490.16 <br /> ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17 <br /> ------------------_________1--------- - - -- --------------- ----- - - <br /> ---- --- - -------'----'- -- - - - --'-- -- ---------------------------------------------------------------- ---- <br /> 490-18 <br /> PROGRAMMED TESTS: ❑ a.0.1 &p.h. ❑ b.0.2 g.p.h. ❑ c.OTHER(Specify): 490-19 <br /> ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490-20 <br /> ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a,36 HOURS ❑ b.60 HOURS 490-21 <br /> 490-zz <br /> ❑ 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 <br /> TEST FREQUENCY: r_1a.ANNUALLY ❑ b.BIENNIALLY [:] c.OTHER(Specify): 490-24 <br /> 490-25 <br /> ❑99.OTHER (Specify): 490-26 <br /> 490-27 <br /> V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) <br /> 1.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-28 <br /> VISUAL ALARMS. (23 CCR§2636) <br /> SECONDARY CONTAINMENT IS:�.DRY [:Ib.-LIQUID FILLED ❑c.PRESSURIZED ❑d.TINDER VACUUM 490-29 <br /> -------------------------- -- ------------------------------------ <br /> PANEL MANUFACTURER: VEE' Y( 0 4- -3o i MODEL#: �-S `;O 490-31 <br /> ------------------------------------------------------ `"e ------C�_1----------------------------------------490-----r--MODEL#($)--'.___.__-* - ----"-'--"'------- 490-33 <br /> LEAK SENSOR MANUFACTURER: <br /> PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. 0'0-.YES E]b.NO 490-34 <br /> FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ®'a.YES ❑b.NO 490-35 <br /> 2.MECHANICAL LINE LEAK DETECTOR(MLLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF <br /> ---------_PRODUCT FLOW WHEN_A LEAK IS DETECTED(23_CCR_ 2636)_--------------------------------------------------------- __ 490-36 <br /> MLLD MANUFACTURER(S): S" 9 37 MODEL#(S) 490-38 <br /> ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490-39 <br /> - ------------------------------------------------------------------------------------------------------- -------------------------' -------------------------------------------------------------- <br /> 490-40. I 490-41 <br /> ELLD MANUFACTURER(S) -- : MODEL#(S): <br /> -- - - - ------------------------------------------------------------------------'------------- ------------------------------------------------------------ <br /> PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.I g.p.h. 490-42 <br /> ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490-43 <br /> ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490-44 <br /> 4.PIPE INTEGRITY TESTING 490-45 <br /> TEST FRE UENCY (3a.ANNUALLY ❑ b.EVERY 3 YEARS ❑ c.OTHER(Specify) 490-46490-47 <br /> ❑ 5.VISUAL PIPE M9NITORtNG. 490-48 <br /> FREQUENCY X1 a.DAILY ❑ b.WEEKLY ❑c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED* 490-49 <br /> "Allowed for monitoring of unburied emergency enerator fuel pipingonlyper HSC§25281,5(b)(3) <br /> ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(a)(3)1. 490-50 <br /> ❑ Z NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM <br /> 490-51 <br /> ❑ 99.OTHER(Specify) 44909o-sz <br /> -53 <br /> UPCF UST-D(12/2007)1/4 <br />
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