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COMPLIANCE INFO 2003 - 2008
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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PR0231118
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COMPLIANCE INFO 2003 - 2008
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Last modified
10/21/2019 3:52:53 PM
Creation date
10/21/2019 3:25:41 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2003 - 2008
RECORD_ID
PR0231118
PE
2371
FACILITY_ID
FA0003284
FACILITY_NAME
FOOD MART GASOLINE*
STREET_NUMBER
2185
Direction
E
STREET_NAME
FREMONT
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
14113045
CURRENT_STATUS
01
SITE_LOCATION
2185 E FREMONT ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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KBlackwell
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EHD - Public
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UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN- Page I of 2) <br /> TYPE OF ACTION ❑ I.NEW PLAN ❑ 2.CHANGE OF INFORMATION 490`1 <br /> PLAN TYPE ❑ 1.MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490-2 <br /> (Check one item only) ❑ 2.THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S)- <br /> I. FACILITY INFORMATION <br /> FACILITY ID#(Agency Use Only) - - I <br /> BUSINESS NAME(Same as FACILITY NAME) 3, <br /> BUSINESS SITE ADDRESS 103, CITY 104. <br /> H.EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE <br /> Testing,preventive maintenance,and calibration of monitoring equipment(e.g.,sensors,probes,line leak detectors,etc.)must be performed at the frequency <br /> specified by the equipment manufacturers'instructions,or annually,whichever is more frequent,and that such work must be performed by qualified personnel. <br /> 23 CCR 2632 2634 2638 2641 <br /> MONITORING EQUIPMENT IS SERVICED ❑ 1.ANNUALLY ❑ 99.OTHER(Specify): a9�0-3b <br /> III.MONITORING LOCATIONS <br /> ❑1.NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. ❑2.SITE PLOT PLAN/MAP PREVIOUSLY SUBMITTED. (23 CCR§2632, <br /> 2634)490-4 <br /> IV.TANK MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): <br /> 1.CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR(INTERSTITIAL)SPACE(S)OR SECONDARY CONTAINMENT 490-5 <br /> VAULT(S)WITH AUDIBLE AND VISUAL ALARMS. (23 CCR§2632,2634) <br /> SECONDARY CONTAINMENT IS: ❑ a.DRY ❑ b.LIQUID FILLED ❑ c.PRESSURIZED ❑d.UNDER VACUUM 490.6 <br /> PANEL MANUFACTURER: 490-7. MODEL#: 490-8 <br /> LEAK SENSOR MANUFACTURER: 490-9 1 MODEL#(S): 490-10 <br /> 2.AUTOMATIC TANK GAUGING(ATG)SYSTEM USED TO MONITOR SINGLE WALL TANK(S).(23 CCR§2643) 490-11 <br /> PANEL MANUFACTURER: 490-12. MODEL#: 490-13 <br /> IN-TANK PROBE MANUFACTURER: 490-14. MODEL#(S): 49045 <br /> LEAK TEST FREQUENCY: ❑ a.CONTINUOUS ❑ b.DAILY/NIGHTLY ❑ c.WEEKLY 490-16 <br /> ❑ d.MONTHLY ❑ e.OTHER(Specify): 490-17 <br /> PROGRAMMED TESTS: ❑ a.0.1 h. ❑ b.0.2 h. ❑ c.OTHERS ci 490-18 <br /> g.p.h. g.p.h. (Specify): 490-19 <br /> ❑ 3.MONTHLY STATISTICAL INVENTORY RECONCILIATION(23 CCR§2646.1): 490.20 <br /> ❑ 4.WEEKLY MANUAL TANK GAUGING(MTG)(23 CCR§2645). TESTING PERIOD: ❑ a.36 HOURS ❑ b.60 HOURS a 022 <br /> 5.TANK INTEGRITY TESTING(23 CCR§2643.1): 490-23 <br /> TEST FREQUENCY: ❑ a.ANNUALLY Elb.BIENNIALLY Elc.OTHER(Specify): 40 zs <br /> 99.OTHER (Specify): 490-26 <br /> E] Pe � a90-27 <br /> V.PIPE MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S)(Check all that apply) <br /> I.CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S)AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-28 <br /> VISUAL ALARMS. (23 CCR§2636) <br /> SECONDARY CONTAINMENT IS:❑a.DRY ❑b.LIQUID FILLED [1c.PRESSURIZED ❑d.UNDER VACUUM 490-29 <br /> PANEL MANUFACTURER 490-30 MODEL#: 490-31 <br /> LEAK SENSOR MANUFACTURER: 490-32 1 MODEL#(S): 490-33 <br /> PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP(i.e.,TURBINE)SHUTDOWN. ❑a.YES ❑b.NO 490-34 <br /> FAILUREIDISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490-35 <br /> 2.MECHANICAL LINE LEAK DETECTOR(MELD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS AND RESTRICTS OR SHUTS OFF <br /> PRODUCT FLOW WHEN A LEAK IS DETECTED 23 CCR 2636 499-36 <br /> MLLD MANUFACTURER(S): 490.37 MODEL#(S): 490-38 <br /> ❑ 3.ELECTRONIC LINE LEAK DETECTOR(ELLD)THAT ROUTINELY PERFORMS 3.0 g.p.h.LEAK TESTS (23 CCR§2636) 490-39 <br /> ELLD MANUFACTURER(S) 490 40 MODEL#(S): 490-x1 <br /> PROGRAMMED IN LINE LEAK TEST: ❑ 1.MINIMUM MONTHLY 0.2 g.p.h. ❑ 2.MINIMUM ANNUAL 0.1 g.p.h. 490-4z <br /> ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 490-43 <br /> ELLD FAILURE/DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑a.YES ❑b.NO 49044 <br /> 4.PIPE INTEGRITY TESTING 490-45 <br /> TEST FREQUENCY a.ANNUALLY b.EVERY 3 YEARS c.OTHER(Specify) 490-4649(1-47 <br /> 5.VISUAL PIPE MONITORING. 490-48 <br /> FREQUENCY ❑ a.DAILY ❑ b.WEEKLY ❑c.MIN.MONTHLY&EACH TIME SYSTEM OPERATED" 490-49 <br /> •Allowed for monitonng of unburied emergency generator fuel piping only per HSC§25281.5(b)(3) <br /> ❑ 6.SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR§2636(a)(3)1. 490-50 <br /> 7.NO REGULATED PIPING PER HEALTH AND SAFETY CODE,DIVISION 20,CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM <br /> 490-51 <br /> 490-52 <br /> ❑ 99.OTHER(Specify) 490.53 <br /> UPCF UST-D(12/2007)1/4 <br />
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