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COMPLIANCE INFO_2006-2008
Environmental Health - Public
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EHD Program Facility Records by Street Name
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COUNTRY CLUB
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1403
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2300 - Underground Storage Tank Program
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PR0231995
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COMPLIANCE INFO_2006-2008
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Last modified
1/18/2023 10:56:18 AM
Creation date
6/3/2020 9:56:07 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2006-2008
RECORD_ID
PR0231995
PE
2361
FACILITY_ID
FA0006438
FACILITY_NAME
United # 5446
STREET_NUMBER
1403
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12323246
CURRENT_STATUS
01
SITE_LOCATION
1403 W COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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SJGOV\rtan
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\MIGRATIONS\UST\UST_2361_PR0231995_1403 W COUNTRY CLUB_2006-2008.tif
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EHD - Public
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'11NUMM PROGRAM CONSOLIDATED FORIV <br /> UNDERGROUND STORAGE TANK !. <br /> MONITORING PLAN Mige 2 of 2) <br /> 1.UDC MONITORING IS PERFORMED USING THE FOLLOWING METHav0OD 49-M <br /> ❑ 1 CONTINUOUS ELECTRONIC MONITORING j2b.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE <br /> ❑4.NO DISPENSERS ❑99.OTHER S <br /> PANEL MANUFACTURER. -40045-1---MODEL# <br /> LEAK SENSOR MANUFACTURER. `'6:'1 MODEL#(S): 490s8 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑ a.YES ❑b.NO <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ❑ a.YES ❑b.NO . <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a YES ❑b.NO 49Mt <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER. a.YES ❑b.NO 490.42 <br /> 2.UDC CONSTRUCTION IS 01.SINGLE-WALLED ❑2 WALLET? 490.03 <br /> IF DOUBLE WALLED: <br /> UDC INTERSTITIAL SPACE IS MONITORED BY. 1.LI UID 2.PRESSURE 0 3.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO <br /> Ll 1 ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT 490-0• <br /> MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS UIRED. 23 CCR 2b94.1) <br /> ®2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVKRY 36 MONTIR 490.0 <br /> 3.SKILL BUCKETS ARE 11 STED ANNUALLY 49wst <br /> The following nXHIi c� are kept for this faetlit)r <br /> C9 Alarm logs a ®Visual Inspection Records 4 ❑Tank integrity testing results a <br /> ❑SIR testing results(and supporting documentation records). 49"u ❑ T (ate supporting documentation records). aso.sse <br /> ❑ATG Testing results(and supporting documentation records).490-M ❑ Corrosion Protectwn 60-day logs a"% <br /> ❑ <br /> Equipment maintenance and calibration records nun <br /> ®Personnel with UST monitoring responsibilities are familiar with all of the following docamneat4 relevant to their job duties. 49o4q. <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) <br /> ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)4go-69b <br /> OPERATING MANUALS FOR ELECTRONIC MONITORING EQiI 4 <br /> CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 4wm <br /> CALIFORNIA UNDERGROUND STORAGE TANK LAW 4 <br /> STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS MANUAL AND <br /> STATISTICAL INVENTORY ILIATION"49r <br /> ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" <br /> ❑ OTHER(Specify): <br /> This facility has a"Designated UST Operate who has passed the Californm UST System Operaw Exam administered by the International Code Council(ICC). <br /> The"Designated UST will traits facility employees in the proper operation and maintenawe of the UST systems ansaudly,and within 30 days of hire.This <br /> training will include,but is not limited to,the following: <br /> A Operation of the UST system in a mamm consistent with the facility's best management practices <br /> A The facilityemployee's role with regard to the monitoring equipment as specified in this UST Monitoring Plan <br /> A The facility employee's rote with regard to spills and overfills as specified in the UST Response <br /> A Nam of s)for emargencies and monitoring alarms.4w.7o <br /> Provide additional comments here or indicate how many pages wltfimformatam on rrronitori are mac hed to this pin.490-71 <br /> ta/4�(�pQ�, �S zD <br /> Y <br /> The UST OwnedOperator is responsible for ansuring that 1)the daily/routine UST monitoring activities and mainlenance of UST leak detection equipment covered by <br /> this plan occurs,2)all conditions that indicate a possift release are investigated,and 3)all monitoring records are maintained property <br /> The fol s)are responsible for performing the monitoring and equipment maintenance- <br /> NAMEStore ftgff 4w-72 TITLE Store 49&73 <br /> NAME Kant Cain 490.74 TITLE District 4W7$ <br /> The Designated Operator shall perform a monthly visual'inspection of the fiality,providea report to ttm ownedoperator,and inform the ownex/operabor of any <br /> conditions that need fallow-up,action. <br /> + kw <br /> CERTIFICATION:I certify that the information dexi herein is true and aecurate to the best of m knowledge. <br /> APPLICANT SIGNATURE <br /> 49o-76 DATE. 490-77 <br /> 5/5108 <br /> APPLICANT NAME(print): 490.78 APPLICANT TITLE: 4W79 <br /> Stephen Boyd HSE SpwiaM <br /> UPCF UST-D(12=n 3/4 <br />
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