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COMPLIANCE INFO_2010-2014
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COMPLIANCE INFO_2010-2014
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Last modified
5/23/2024 3:25:18 PM
Creation date
6/3/2020 9:50:12 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2010-2014
RECORD_ID
PR0231497
PE
2361
FACILITY_ID
FA0000279
FACILITY_NAME
ESCALON MINI MART
STREET_NUMBER
1097
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
ESCALON
Zip
95320
APN
22510001
CURRENT_STATUS
01
SITE_LOCATION
1097 YOSEMITE AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
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\MIGRATIONS\UST\UST_2361_PR0231497_1097 YOSEMITE_2010-2014.tif
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EHD - Public
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e <br /> UNIFIED PROGRAM CONSOLIDATED FORMW <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN (Page 2 of 2) <br /> VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING <br /> 1.JMt MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490-549 <br /> 490-546 <br /> 1.CONTINUOUS ELECTRONIC MONITORING ❑2.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE <br /> ❑4.NO DISPENSERS ❑99.OTHER(Specify): <br /> PANEL MANUFACTURER: 4W55 MODEL#: 490-56. <br /> LEAK SENSOR MANUFACTURER 490-57 MODEL#(S): 490-59 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ES ❑b.NO 490.59 <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN YES ❑b.NO 490.60. <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ,� aYES (3b.NO 49"1 <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER LT ate..YES ❑b.NO 4 .62 <br /> 2.UDC CONSTRUCTION IS ff SINGLE-WALLED ❑2.DOUBLE-WALLED 490-63 <br /> IF DOUBLE WALLED: 490- <br /> UDC INTERSTITIAL SPACE IS MONITORED BY: I.LIQUID 2.PRESSURE 3.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO 49""b <br /> VII.PERIODIC SYSTEM TESTING <br /> 1. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 4—. <br /> MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED. 23 CCR 2644.1 <br /> Odf`SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490.66 <br /> 04.;WILL BUCKETS ARE TESTED ANNUALLY. 440.67 <br /> VIII.RECORDIMPING <br /> The following monitoring/maintenance records are kept for this facility: <br /> Alarm logs 490.69& ❑Visual Inspection Records 490 68h Tank integrity testing results a <br /> SIR testing results(and supporting documentation records). 4.0 Tank gauging results(and supporting documentation records). 49a69e <br /> ATG Testing results(and supporting documentation records).490.69E §Corrosion Protection 60-day logs 49"ss <br /> ❑Equipment maintenance and calibration records. 490-68h <br /> UL TRA G <br /> ❑Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 490.694 <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all thatapply) <br /> 13 THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) 9b <br /> OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)a <br /> CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490.69d <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW 4904% <br /> ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND <br /> STATISTICAL INVENTORY RECONCILIATION"490-69r <br /> ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"4go-69s <br /> ❑ OTHER(Specify):M69k m69i <br /> Ll 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 /> B 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.49o-7o <br /> X. CONEVIENTSIADDITIONAL INFORMATION <br /> Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan.49o-7i <br /> M.PERSONNEL RESPONSIBIIJTIES <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 49D.72 TITLE 49x73 <br /> NAME 4goa4 TITLE 49Da5 <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!Ln o led e- <br /> APPLICANT SIGNATURE 49x76 DATE: 490-77 <br /> APPLICANT NAME(print): g490-78 APPLICANT TITLE: <br /> /OV t� <br /> UPCF UST-D(12/2007)3/4 <br />
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