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BILLING 2008 - 2015
Environmental Health - Public
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EHD Program Facility Records by Street Name
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KETTLEMAN
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2300 - Underground Storage Tank Program
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PR0506724
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BILLING 2008 - 2015
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Entry Properties
Last modified
10/20/2021 3:39:12 PM
Creation date
11/5/2018 3:33:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
2008 - 2015
RECORD_ID
PR0506724
PE
2361
FACILITY_ID
FA0007594
FACILITY_NAME
WINE COUNTRY STATION/7-ELEVEN
STREET_NUMBER
1111
Direction
E
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04931056
CURRENT_STATUS
01
SITE_LOCATION
1111 E KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\K\KETTLEMAN\1111\PR0506724\BILLING 2008 - 2015.PDF
QuestysFileName
BILLING 2008 - 2015
QuestysRecordDate
6/27/2018 3:57:23 PM
QuestysRecordID
3926436
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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UNDERGROUND STORAGE TANK <br /> MONITORING PLAN - PAGE 2 <br /> VI. DISPENSER MONITORING <br /> M1-11 OF AREAS BENEATH DISPENSER(S)IS PERFORIALD USING THE FOLLOWING METHOD(S)(Check all that apply) M50. <br /> C.CONTINUOUS ELECTRONIC MONITORING OF UNDER DISPENSER CONTAINMENT(UDC) <br /> PANEL MANUFACTURER: M51. MODEL P. N15Z <br /> LEAK SENSOR MANUFACTURER: Mss. MODEL#(S) ,—— «r M54 <br /> WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? -*t.YES ❑ b.NO Mss. <br /> WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? —T�7.YES ❑ b-NO M56. <br /> WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN?rER 2r YES ❑ b.NO M57. <br /> 2.MECHANICAL ASSEMBLY(e.g.,FLOAT AND CHAIN ASSEMBLY)IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK <br /> ASSEMBLY MANUFACTURER: IZ R"0 MSa. MODEL#(S): M59. <br /> L-<VISUAL MONITORING DONE: "a.DAILY ❑ b.WEEKLY{Requires agencyappmval) M60. <br /> 4.NO DISPENSERS <br /> ❑ 99 OTHER(Specify) M61 <br /> VIL. ENHANCED LEAK DETECTION <br /> 1 WE HAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT WE MUST IMPLEMENT ENHANCED LEAK R170. <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 /> REF RENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) Mao. <br /> 1. THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) <br /> 2. 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. J 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, Ll OTHER(Specify): Mat. <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 ofthe UST systems in a manner consistent with the facility's best management practices. <br /> v The facility employee's role with regard to the leak detection equipment. <br /> Y 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): n185. <br /> X. PERSONNEL RESPONSIBILITIES <br /> AS OF 111105, 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 /> XY. OWNER/OPERATOR SIGNATURE <br /> CERTIFICATION:I certfy that the information provided herein is true and accurate to the best of my knowledge. <br /> pWNER/1�PERATJ�pq�R SIGNA RE rR--E�PRESENTING DATE: Met, <br /> l� r/ i El owner M90 <br /> *\]�/I L�r^--"V <br /> El operator 04RL-� <br /> OWNER/OPERATOR NAME(print): M92. OWNER/OPERATOR TIT M93 <br /> (Agency Use Only) This plan has�beeln reviewed and: Approved El Approved With Conditions El Disapproved <br /> Local Agency Signature: #- Date: <br /> Comments/Special Conditions: M M L 2 <br /> SJCEHD-d(07103)-314 ) ae -e M-,L t AA����j 07/23/03 <br /> to <br /> �r <br />
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