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COMPLIANCE INFO_2009-2015
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0232519
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COMPLIANCE INFO_2009-2015
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Last modified
1/3/2024 2:00:21 PM
Creation date
6/3/2020 9:57:37 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2009-2015
RECORD_ID
PR0232519
PE
2361
FACILITY_ID
FA0000483
FACILITY_NAME
BILLS 76
STREET_NUMBER
633
Direction
E
STREET_NAME
VICTOR
STREET_TYPE
RD
City
LODI
Zip
95240
APN
04321055
CURRENT_STATUS
01
SITE_LOCATION
633 E VICTOR RD STE A
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
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FilePath
\MIGRATIONS\UST\UST_2361_PR0232519_633 E VICTOR_2009-2015.tif
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EHD - Public
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A <br /> MW UNIFIED PROGRAM CONSOLIDATED FOOM <br /> UNDERGROUND STORAGE TANK <br /> MONITORING PLAN (Page 2 of 2) <br /> VI.UNDER DISPENSER CONTAINMENT(UDC)MONITORING <br /> 1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490'34 <br /> 111.CONTINUOUS ELECTRONIC MONITORING 112.FLOAT AND CHAIN ASSEMBLY ❑ 3.ELECTRONIC STAND-ALONE 490-54b <br /> ❑4.NO DISPENSERS 1199.OTHER(Specify): <br /> PANEL MANUFACTURER: a90-ss MODEL M 490-56. <br /> LEAK SENSOR MANUFACTURER 490-57 MODEL#(S): 490.59 <br /> DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑ a.YES ❑b.NO 490.59 <br /> UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ❑ a.YES ❑b.NO 490-60. <br /> FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ❑ a.YES ❑b.NO 49"] <br /> UDC MONITORING STOPS THE FLOW OF PRODUCT AT THE DISPENSER ❑ a.YES ❑b.NO 490.62 <br /> 2.UDC CONSTRUCTION IS ❑1.SINGLE-WALLED ❑2.DOUBLE-WALLED 49"3 <br /> IF DOUBLE WALLED: 490.64a <br /> UDC INTERSTITIAL SPACE IS MONITORED BY: Ej 1.LIQUID 2.PRESSURE 3.VACUUM <br /> A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS ❑a.YES ❑b.NO 490-64b <br /> VII.PERIODIC SYSTEM TESTING <br /> I. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490.65. <br /> DI MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED. 23 CCR 2644.1 <br /> ❑2.SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490.66 <br /> 3.SPILL BUCKETS ARE TESTED ANNUALLY. 490.67 <br /> VIII.RECORDKEEPING <br /> The following monitoring/maintenance records are kept for this facility: <br /> Alarm logs 4va69a ❑Visual Inspection Records 490-69b ❑Tank integrity testing results 490-68c <br /> SIR testing results(and supporting documentation records). 4%-Md ❑ Tank gauging results(and supporting documentation records). 49G-6se <br /> ATG Testing results(and supporting documentation records).49"8f U Corrosion Protection 60-day logs 4sa69g <br /> ❑Equipment maintenance and calibration records. 490-69b <br /> IX.TRAINING <br /> ❑Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 4gw-69a <br /> REFERENCE DOCUMENTS MAINTAINED AT FACILITY(Check all that apply) <br /> ❑ THIS UNDERGROUND STORAGE TANK MONITORING PLAN(Required)490b9b <br /> OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT(Required)49o-69c <br /> CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490-69d <br /> CALIFORNIA UNDERGROUND STORAGE TANK LAW 490-69e <br /> STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND <br /> STATISTICAL INVENTORY RECONCILIATION"49M9f <br /> ❑ SWRCB PUBLICATION:"UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS"49D-698 <br /> ❑ OTHER(Specify):M69h,M69i <br /> This facility has a"Designated UST Operator"who has passed the California UST System Operator Exam administered by the International 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 30 days of hire.This <br /> 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 monitoring equipment as specified in this UST Monitoring Plan <br /> • The facility employee's role with regard to spills and overfills as specified in the UST Response Plan <br /> ➢ Names of contact person(s)for emergencies and monitoring alarms.490-7o <br /> X. CONEMWMSIADDMONAL INFORMATION <br /> Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan.4911-7i <br /> XI.PERSONNEL RESPONSIBILITIES <br /> The UST Owner/Operator is responsible for ensuring that:1)the daily/routine UST monitoring activities and maintenance of UST leak detection equipment covered by <br /> this plan occurs,2)all conditions that indicate a possible release are investigated,and 3)all monitoring records are maintained properly. <br /> The following person(s)are responsible for performing the monitoring and equipment maintenance: <br /> NAME 49o-72 TITLE 490-73 <br /> NAME 49o-74 TITLE 490-75 <br /> The Designated Operator shall perform a monthly visual inspection of the facility,provide a report to the owner/operator,and inform the owner/operator of any <br /> conditions that need follow-up action. <br /> XII.OWNER/OPERATOR SIGNATURE <br /> CERTIFICATION:I certify that the information provided herein is true and accurate to the best of my knowledge. <br /> APPLICANT SIGNATURE 490-76 DATE: 490.77 <br /> APPLICANT NAME(print): 490.78 APPLICANT TITLE: 490"79 <br /> UPCF UST-D(12/2 3/4 <br />
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