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BILLING_PRE 2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231532
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BILLING_PRE 2019
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Entry Properties
Last modified
10/4/2022 2:28:59 PM
Creation date
11/2/2018 3:58:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0231532
PE
2351
FACILITY_ID
FA0000185
FACILITY_NAME
CITY FOOD & LIQUOR
STREET_NUMBER
16470
STREET_NAME
CAMBRIDGE
STREET_TYPE
ST
City
LATHROP
Zip
95330
APN
19643032
CURRENT_STATUS
03
SITE_LOCATION
16470 CAMBRIDGE ST
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\C\CAMBRIDGE\16470\PR0231532\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
10/23/2012 8:00:00 AM
QuestysRecordID
132740
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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UNIFIED PROGRAM CONSOLWATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORINGPLAN (Page29172) <br /> . -VL.j .t .�Yb=DI ,$N >gR-COP1U MONVORING: - <br /> 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 190-14 <br /> 490-Sea <br /> ❑ 1.CONTINUOUS ELECTRONIC MONITORING 1912.FLOAT AND CHAIN ASSEMBLY ❑ 1.ELECTRONIC STAND-ALONE <br /> 114.140 DISPENSERS_ 1199.OTHER(SpecifyE_�_____-_� <br /> PANEL MANUFACTURER: 490'55 MODEL N: 49036. <br /> LEAK SENSOR MANUFACTURER: 490-57 MODEL U(S): 49°-59 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑ LYES Ob.NO 4saw <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ❑ a YES N b.NO <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ®b.NO 490.61 <br /> UDC MONITORING STOPS THE FLOW OF PRODUCTATTHE DISPENSER. N a.YES ❑b.NO 490.51 <br /> 2.UDC CONSTRUCTION IS ®I.SINOL&WALLED ❑ 2.DOUBLE-WALLED 490.63 <br /> IF DOUBLE WALLED: asnax <br /> UDC INTERSTITIAL SPACE IS MONITORED BY: Q I.LIQUID ❑2.PRESSURE ❑3.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑LYES ❑b.NO 4sa5K <br /> V11.PERIODIC SYSTEM TESTING <br /> I. ELD TESTING:THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 49a61. <br /> N IELDI MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED..L23 CCR 2694.1 <br /> ®2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. <br /> --3.SPILL BUCKETS ARE TESTED ANNUALLY. Y 4gp53 <br /> VLII.RECORIHOOPINO <br /> The following monilodngfmaintenanw records are kept Por this facility. <br /> H Alum logs W-. ❑Visual Inspection Records 4wan6 ❑Tank integrity testing results 49a ca. <br /> ❑SIR toting results(and supporting documentation records). 4sa°ad ❑ Tank gauging results(and supporting documentation records). 4soaas <br /> ❑ATO Toting results(and supporting documentation records).4soasr ❑ Comosien Protection 6e-day logs 4soasa <br /> H Equipment mainlenuies and calibration records. 4rossa <br /> H Personnel with LIST monitoring responsibilities aro familiar with all of the following documents relevant to Iheirjob duties. 4mm <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check.all that apply) <br /> H THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)49a69D <br /> N OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)49664 <br /> ❑ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS aab5sd <br /> ❑ CALIFORNIA UNDERGROUND STURAGBTANK LAW 4r0.6ad <br /> ❑ STATE WATPR,.RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND <br /> STATISTICAL INVENTORY RECONCILIATION"eroaw <br /> ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK OAUGINO SYSTEMS"ata-5va <br /> ❑ OTHER(Speciry):;,a;k MW <br /> Pg This facility has o"Designated UST Operator"who has passel the Caltfomie UST System Operator Exam administered by the Intcriational 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 3o days or hire.This <br /> training will include,but is not limited to,the following: <br /> D Operation of the UST systems in a manner consistent with the facility's bot management practices <br /> D The Pocility employee's role with regard to the monitoring equipment as specified in this UST Monitoring Plan <br /> D The fscibiry employee's rale with regard to spills and overfills o specified in the UST Response Plan <br /> D Names of contact person(')for emagencies and monitoring alums.a as <br /> X. COMMENTS/AODM-IONALINFORMATION <br /> Provide additional canmenis lure or Indicate how many pages with additional infarmntion on specific monitoring procedures are attached to this plan.~i <br /> oveeflu. PREVENTow Flo" V41ft @,95% <br /> r XL PERSONNEL RESPONSIBILITIES <br /> The UST OwnerlOperalor is responsible for ensuring that:1)the daily/routine UST monitoring activities and maintenance or UST leak detooto equipment covered by <br /> this plan occurs,2)all conditiom[lint indicate a possible release am investigated,and 3)all monhoring records are maintained property. <br /> The following person(s)am responsible for performing the monitoring and equipment maintenance: <br /> NAME Service Contact Center 4v i:i TITLE: 24HourCal I Center 4 13 <br /> NAME Rudy Tovar « 74 TITLE Market Managa 490 <br /> The Designated Operator shall palorhn a monthly visual inspection of the Witty,provide a report to the owns rfopemtar,and inform the ovnnu/operate or any <br /> conditions am and follow-up action. <br /> XII.OWN WOPER'ATOR SIGNATURE <br /> CERTIFICATION:1 mrtify that the information pmvided herein is true and accurate to the best of my knowledge. <br /> APPLICANT SIQNATURE 49&36 DATE:-AUAUQM 49LL90 <br /> Zr .. <br /> APPLICANT NAME(print): 440"36 APPLICANTTITLE: 450.59 <br /> Rich Gossett Environmental Compliance Manager <br /> nnnn ua-r n n+nnm3+u <br />
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