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COMPLIANCE INFO_2003-2011
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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88 (STATE ROUTE 88)
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14971
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2300 - Underground Storage Tank Program
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PR0231911
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COMPLIANCE INFO_2003-2011
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Last modified
11/20/2024 9:21:33 AM
Creation date
6/23/2020 6:53:37 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2003-2011
RECORD_ID
PR0231911
PE
2361
FACILITY_ID
FA0000540
FACILITY_NAME
COUNTRYSIDE LIQUORS & GAS
STREET_NUMBER
14971
Direction
N
STREET_NAME
STATE ROUTE 88
City
LODI
Zip
95240
APN
06316025
CURRENT_STATUS
01
SITE_LOCATION
14971 N HWY 88
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231911_14971 N HWY 88_2003-2011.tif
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EHD - Public
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UNDERGROUND STORAGE TANK <br /> MONITORING PLAN-PAGE 2 <br /> VI.DISPENSER MONITORING <br /> MONITORING OF AREAS BENEATH DISPENSER(S)IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) M50. <br /> ,a 1.CONTINUOUS ELECTRONIC MONITORING OF UNDER DISPENSER CONTAINMENT(UDC) <br /> PANEL MANUFACTURER: S/ g.(29 90�'_T M51. MODEL#: M52. <br /> LEAK SENSOR MANUFACTURER: A_m r M53 MODEL#(S): GK1 Msa. <br /> WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? (� a.YES ❑ b.NO Mss. <br /> WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? a.YES ❑ b.NO M56. <br /> WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? a.YES ❑ b.NO MST <br /> ❑ 2.MECHANICAL ASSEMBLY(e.g.,FLOAT AND CHAIN ASSEMBLY)IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK <br /> ASSEMBLY MANUFACTURER: M58 MODEL#(S): M59. <br /> ❑ 3.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(Requires agency approval) M60 <br /> ❑ 4.NO DISPENSERS <br /> ❑ 99.OTHER(Specify) M61. <br /> VII. ENHANCED LEAK DETECTION <br /> ❑ 1.WE HAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT WE MUST IMPLEMENT ENHANCED LEAK M70 <br /> DETECTION(ELD)FOR THE UST(S)COVERED BY THIS PLAN.PER 23 CCR§2644.1,ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED <br /> VIII. TRAINING <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) Mso. <br /> 1. (9 THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) <br /> 2. c OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) <br /> 3. ❑ THE FACILITY'S BEST MANAGEMENT PRACTICES(Required as of 1/01/2005) <br /> 4. ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS <br /> 5. ❑ CALIFORNIA UNDERGROUND STORAGE TANK LAW <br /> 6. ❑ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND <br /> STATISTICAL INVENTORY RECONCILIATION" <br /> 7. ❑ SWRCB PUBLICATION:"WEEKLY MANUAL TANK GAUGING FOR SMALL UNDERGROUND STORAGE TANKS" <br /> 99. ❑ OTHER(Specify): Mill. <br /> Personnel with UST monitoring responsibilities are familiar with all of the above documents relevant to their job duties and can access those documents when needed. <br /> By January 1,2005 this facility will have a"Designated UST Operator"who has passed the operator exam administered by the International Code Council(ICC). By <br /> January 1,2005,and annually thereafter,the "Designated UST Operator"will train facility employees in the proper operation and maintenance of the UST systems. <br /> 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 leak detection equipment. <br /> ➢ The facility employee's role with regard to spills and overfills. <br /> ➢ Whom to contact for emergencies and leak detection alarms. <br /> For facility employees hired on or after January 1,2005,the initial training will be conducted within 30 days of the date of hire. <br /> IX. COMMENTS/ADDITIONAL INFORMATION <br /> Please use this section to include any additional UST system monitoring-related information(e.g.,additional information required by your local agency): Mss. <br /> X. PERSONNEL RESPONSIBILITIES <br /> AS OF 1/1/05, THE "DESIGNATED UST OPERATOR" IDENTIFIED IN SECTION III OF THE CURRENT UST OPERATING PERMIT APPLICATION— <br /> FACILITY FORM WILL HAVE ULTIMATE AUTHORITY FOR PERFORMING THE MONITORING ACTIVITIES AND MAINTAINING LEAK DETECTION <br /> EQUIPMENT COVERED BY THIS PLAN,AND WILL PERFORM AND DOCUMENT MINIMUM MONTHLY VISUAL INSPECTIONS OF THE FACILITY'S <br /> UST SYSTEMS IN ACCORDANCE WITH 23 CCR§2715(b). <br /> XI. OWNER/OPERATOR SIGNATURE <br /> CERTIFICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. <br /> OWNER/OPERATOR SIGNATURE REPRESENTING DATE: ,[ M91. <br /> Owner <br /> M9o. <br /> Operator <br /> OWNER/OPERATOR NAME(print): M92. OWNER/OPERATOR TITLE: M93. <br /> Ir, M&\IA61 I _(Y( <br /> (Agency Use Only) This plan has been reviewed and: -Approved ❑Approved With Conditions ❑Disapproved <br /> Local Agency Signature Date: <br /> Comments/Special Conditions: <br /> SJCEHD-d(07/03)-3/4 07/23/03 <br />
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