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COMPLIANCE INFO_2006-2018
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PR0231736
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COMPLIANCE INFO_2006-2018
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Last modified
11/29/2023 12:42:29 PM
Creation date
6/23/2020 6:51:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2006-2018
RECORD_ID
PR0231736
PE
2361
FACILITY_ID
FA0002562
FACILITY_NAME
Sutter Valley Hospitals dba Sutter Tracy Community Hospital
STREET_NUMBER
1420
Direction
N
STREET_NAME
TRACY
STREET_TYPE
Blvd
City
Tracy
Zip
95376
APN
233-081-01
CURRENT_STATUS
01
SITE_LOCATION
1420 N Tracy Blvd
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\rtan
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FilePath
\MIGRATIONS\UST\UST_2361_PR0231736_1420 N TRACY_2006-2018.tif
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EHD - Public
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Dec" 09 2009 12: 27PM STCH MAINTENANCE 2098326070 P. G <br /> 1jWjNIFIE1D PROGRAM CONSOLIDATED FORMW <br /> UNDERGROUND STORAGE TANK <br /> 7MONITORING PLAN-(rag!I of 21 <br /> TYPE OF ACTION ❑ 1.NEW PLAN2.CHANGE OF rNFOWMATION 490-1 <br /> PLAN TYPE I-MONITORING IS IDENTICAL FOR ALL UST8 AT THIS FACIL[Ty. 490.2 <br /> (Check one item only) Q 2,THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM a! <br /> L FACILITY INFORMATION <br /> FACILITY ID#(Agerej <br /> y Ura Onv) -T 1 --7- 1 1 1 <br /> BUSINESS NAME(Some as FACILITY NAME) 3. <br /> N• -'rha& <br /> BUSINESS SITE ADDRESS tx 1 04 <br /> 1 , <br /> I-lav y103. ol <br /> 11.EQUnWZXT TESTING AND PREVIMTIVE MAINTENANCE <br /> Tasting,preventive maintenance,and calibration of monitoring cqWpment(e.g.,scz=s,probes,ligm leak detectors,ctc.)must be performed at the frequency <br /> specified by the equipment manufhottuvral instructions,or amually,whichever is mom flvquent,and that such work mm be porfannod by qualified pamo=el, <br /> _L21g2R2L32.2631M <br /> ., 38 <br /> L _ _ <br /> MONITORING EQUIPMENT IS SERVICED 1.ANNUALLY ❑ 99,OTHE490"34R(SpeoifY); 490-3b <br /> IH.MONrrOMG LOCATIONS <br /> Ej 1.NEW SITE PLOT PLARRAP suamnTED WITH THIS PLAN. 2.SITE PLOT PLANNAP PREVIOUSLY SUB D, (23 CCR 42632, <br /> 26WQo,4 <br /> IrV.TANK MONITORING IS PERFORMED USING THE FOLLOWING MEMOD(S): <br /> go 1.CONTINUOUS ELECTRONIC TANK MONITORING or ANNULAR(INTERSTITIAL)SPACE(S)On SECONDARY CONTAINMENT M-3 <br /> VAULT($)WITH AUDIBLE AND VISUAL ALAjtMS. (23 CCR 42632,2634) <br /> SECONDARY CONTAINMENT IS: C3 A.DRY 0 b.LIQUID FILLED PRESSURIZED 0 d,UND13R VACUUM 4CA66 <br /> --PANEL M&NUFACTURER: 4905 <br /> LEAK SENSOR MANUFACTURER: e. ®90-4' MODEL#S � 490-10 <br /> -=2,AUTOMATIC TANK GAUGIT-4r.(ATG)SYSTEM USED TO MONITOR SINGLE WALL j&U[5j 3CCR§2643) <br /> 490.11 <br /> PANEL MANUFACTURER: 4Wil MODEL#: 4Wn <br /> IN-TANK PROSE MANUFACTURER: S <br /> MODEL 440-Is <br /> L 1 <br /> LEAK TEST FREQUENCY: C3 a.CONTiRUdUE-S ---" -13 b.DAIL--YINIGHTLY cl C.WMKLY 490-16 <br /> E3 (L MON THLY1. <br /> *.OTHER <br /> PROGRAMMED TESTS: C3 a.0.1 g.PJ3. Ll b.0.2 g.p h. [3 c.OTHER(Sp=ify)- <br /> 490-19 <br /> 0 3,MONTHLY STATISTICAL INVENTORY RECONCILIATION(23CCR§2646.0; 490-20 <br /> (3 4,WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR 42645). TESTING PERIOD: 0 &36 Houn ❑ b.60 HOURS 490-21 <br /> 49&22 <br /> -T TANK INTEGRITY TESTING(23 CCR J2643.1): 41X-23 <br /> TEST FREQUENCY: [3a.ANNUALLY 0 b.31137NNIALLY 0 c'OTMR(Sp"): 49r-24 <br /> 490.24 <br /> ❑99.OTHER (specify): 4MZS <br /> 49629 <br /> V.PIPE MONITORING IS PERFORMW USING TEM FOLLOWING MXTHOD(9)(Ch"k AU that apply) <br /> RI.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 4 -39 <br /> SUAL ALARMS. (23 CCR§206) <br /> SECONDARY CONTAINMENT IS:Za.DRY 0b,LIQUID FILLED [3c.PRESSURIZED Od.UNDER VACUUM 490-29 <br /> PANEL MANUFACTURVIL490-30 ]_MODEL 0: 440.3 1 <br /> LEAK SrzN$QR MANUFACTURER- 49" ------- <br /> PIPING LEAK ALA"TRI001311.3 AUTOMATIC PUMP(i.e.,TU"114]5)SHUTDOWN. n-a-y--ES'w- h NO 49G.34 <br /> FAILURFJOISCONNECTION OF THE MONITOPJNQ SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. C3 a.YES a b.NO 490.33 <br /> U 2.MECHANICAL LH%X LEAK DF LECTOR(MLLD)THAT ROUM-ELY PERFORMS 1.0 gp.11.LEAK Tff-VM AND RXSTRICTS OR SHUTS OFF <br /> -PRODUCT FLOW WHEN A LEAK IS DETRCTIM.L11 CCA263¢) --- -..- 490-36 <br /> MLLD MANUFACTURE M): 4W;I- MODEL t8j "Nit <br /> C1 3.ELECTRONIC LINE LEAK DETECTOR(ILLD)THAT ROUTINELY PERF ORNIS 3.0 lgpla.LEAK TESTS (23 CCR 42" <br /> BUD MANUFACTURE S) <br /> -L-MODEL 4(9). <br /> PROGRAMMED IN LINE LEAK TEST: 0 I.MINIMUM MONTHLY 0.2S.p,h, ❑ 2.MINIMUM ANNUAL 0.12 <br /> 400-42 <br /> EUD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. 0 a.YES 0 b.NO 49043 <br /> ELLD FAALURFJDISCONNSCMN TRIGGERS AUTOMATIC PUMP SHUTDOWN. C3 a.YES E3 b.NO 49044 <br /> -=4.PIPE INTEGRITY TESTING 49 4s -- <br /> TEST FMOUI <br /> 15MY M LANNIJALLY [I li.EVERY 3YEARS 0 C'OTHLrg(8p"& <br /> =5. 4 46 00 <br /> 90VISUAL PIPE MONITORING.C3 490-47 <br /> -48 <br /> FREQUENCY 0 a,DAILY b.WEEKLY C3 o.mm MONTHLY&zAcH T=SySTM()pMATEW 490A9 <br /> # rm:gOw'd farmmtoals of . Elengrawr 1--f.-fiscAld, <br /> 6.SUCTION PIPING MEET$EXEMPTION CRITERIA[23 CCR§2636(a)(3)j. <br /> 4W50 <br /> 21,7.NO REGULATED PIPING PIM HEALTH AND SAFETY CODE,DIVISION all,CHAPT21 6.713 CONNECT-ED TOTHE TANK SYSTEM <br /> 490-51 <br /> C3 99-OTHER(SpocW) 490-52 <br /> 49653 <br /> J <br /> UPCF UST-D(1213007)1/4 <br />
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