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BILLING 2005 - 2007
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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PR0523684
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BILLING 2005 - 2007
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Entry Properties
Last modified
11/7/2023 2:01:52 PM
Creation date
11/6/2018 12:46:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
2005 - 2007
RECORD_ID
PR0523684
PE
2351
FACILITY_ID
FA0015977
FACILITY_NAME
Fast Lane Central Valley
STREET_NUMBER
116
STREET_NAME
ROTH
STREET_TYPE
Rd
City
Lathrop
Zip
95330
APN
196-02-020
CURRENT_STATUS
01
SITE_LOCATION
116 Roth Rd
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\R\ROTH\116\PR0523684\BILLING 2005 - 2007.PDF
QuestysFileName
BILLING 2005 - 2007
QuestysRecordDate
4/24/2018 10:12:57 PM
QuestysRecordID
3865714
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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• • <br /> Underground Storage Tank Monitoring Plan—Page 2 of 2 <br /> VI.DISPENSER MONITORING <br /> MONITORING OF AREAS BENEATH DISPENSER(S)IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) M6°. <br /> 9�4.CONTINUOUS ELECTRONIC MONIT RING1^OnF�✓UND^ER i/yTSPENSER CONTAINMENT(UDC) <br /> PANEL MANUFACTURER: [ 4� / /R.�e-c�'r ec c,l M51. MODEL 4: O W2, <br /> LEAK SENSOR MANUFACTURER: M" MODEL#(S): y 3 O ` O M54. <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 M" <br /> WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? a.YES ❑ b.NO M" <br /> ❑ 2.MECHANICAL ASSEMBLY(e.g,FLOAT AND CHAIN ASSEMBLY)IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK <br /> ASSEMBLY MANUFACTURER: Mse. MODELN(S): M59. <br /> ❑ 3.VISUAL MONITORING DONE: ❑ a.DAILY ❑ b.WEEKLY(aegwre:smrr aam"va) n4e°. <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 M'!0. <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) M80. <br /> I. no�f THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required) <br /> 2. y9 OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required) <br /> 3. ❑ THE FACILITY'S BEST MANAGEMENT PRACTICES(Required as of January 1,2005) <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): M81 <br /> Personnel with UST monitoring responsibilities are familiar with all of the above documents relevant to theirjob 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 California UST Sytem Operator Exam administered by the International <br /> Code Council(ICC). By July 1,2005,and annually thereafter,the "Designated UST Operator"will train facility employees in the proper operation and maintenance <br /> of the UST systems.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 July 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 /> Note regarding Section X.Pending certification of a Designated UST Operator,the following person has authority for performing the monitoring <br /> activities and maintaining leak detection equipment covered by this plan. NAME: JOB TITLE: <br /> a-4- qo% ill IrT` 1 . <br /> X. PERSONNEL RESPONSIBILITIES <br /> AS OF JANUARY 1, 2005, THE "DESIGNATED UST OPERATOR" IDENTIFIED IN SECTION III OF THE CURRENT UST OPERATING PERMIT <br /> APPLICATION-FACILITY FORM WILL HAVE ULTIMATE AUTHORITY FOR PERFORMING THE MONITORING ACTIVITIES AND MAINTAINING <br /> LEAK DETECTION EQUIPMENT COVERED BY THIS PLAN,AND WILL PERFORM AND DOCUMENT MINIMUM MONTHLY VISUAL INSPECTIONS <br /> OF THE FACILITY'S UST SYSTEMS IN ACCORDANCE WITH 23 CCR§2715(b). <br /> XI. OWNER/OPERATOR SIGNATURE <br /> CERTIFIC IO I ceptily that Ihe information provided herein is true and accurate to the hest of my knowledge. <br /> OWNER/OP TO FRE RE RESENTING DATE: M51. <br /> er Mso. G .h"� <br /> ❑Operator O lJ / <br /> OWNER/ TO rint): II M93 OWNER/�P jt/TOR TITLE: M93 <br /> (Agency Use Only) This plan has <br /> lrbeg <br /> !� reviewed and: Approved C]Approved With Conditions ❑Disapproved <br /> • Local Agency Signature: • 1 V tT Date: I <br /> Comments/Special Conditions: <br /> UN-022A-3/5 www.uniducs.org Rev.10/14/03 <br />
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