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COMPLIANCE INFO 2014 - 2015
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0516526
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COMPLIANCE INFO 2014 - 2015
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Last modified
5/28/2019 11:15:30 AM
Creation date
10/19/2018 3:11:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO 2014 - 2015
FileName_PostFix
2014 - 2015
RECORD_ID
PR0516526
PE
2361
FACILITY_ID
FA0012659
FACILITY_NAME
LOVE'S COUNTRY STORES OF CALIF #223
STREET_NUMBER
1553
STREET_NAME
COLONY
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
24534024
CURRENT_STATUS
01
SITE_LOCATION
1553 COLONY RD
P_LOCATION
05
P_DISTRICT
005
QC Status
Approved
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KBlackwell
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EHD - Public
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RECEIVED <br />-JUL 2 8 2014 <br />ENVIRONIA TALfHEALTH <br />SWRCB, January 2002 ��I�� T�F�� <br />A PTPTNf CTWP TFfiTTNt� <br />Test Method Developed By: ❑ Sump Manufacturer 0 Industry Standard X Professional Engineer <br />0 Other (Spechj) <br />Test Method Used: 0 Pressure ❑ Vacuum X Hydrostatic <br />0 Other (Spec) _ _ - <br />Test Equipment Used: TS -STS icon sump test system <br />Equipment Resolution: 2.101 <br />Sump # <br />Sump it <br />Sump # — —" <br />S11111p # I <br />Sump Diameter: <br />Sump Depth:__ <br />-- <br />Sump Material: <br />Height fix» rr Tank Top to Top of <br />Highest Piping Penetration: <br />Height from Tank Top to Lowest <br />Electrical Penetration: <br />Condition of sump prior to testing. <br />Portion of Sump Tested' <br />Does turbine shut down when <br />sump sensor detects liquid (both ❑ Yes 0 No 0 NA <br />D Yes DNo DNA <br />0 Yes ❑ No DNA <br />0 Yes ❑ No UNA <br />product and water)?* <br />.......... <br />Turbine shutdown response time 15 see <br />15 sec <br />t5 see <br />is sec <br />Is system programmed for fail-safe 0 Yes D No 0 NA <br />D Yes ONo ❑ NA <br />0Yes ONo DNA <br />n Yes DNo ❑ NA <br />shutdown? <br />Was fail-safe verified to be ❑Yes 0 N DNA <br />DYes DNo ❑NA <br />❑Yes ❑No DNA <br />OYes DNo DNA <br />operational?* <br />_ <br />Wait time between applying <br />pressure/vacuum/water and starting <br />test: <br />Test Start Time: <br />Initial Reading (Rr): <br />Test End Time: <br />Final Reading (R,,): <br />........... <br />Test Duration: 15 min <br />_.. <br />15 uliu <br />15 11011 <br />15 min <br />Change in Reading (RF -R1): <br />Pass/Fail Threshold or Criteria: .002 <br />.00.2 <br />.002 <br />.002 <br />Test Result: 0 Pass ❑ Fail <br />0 Pass ❑ Fail <br />❑ Pass ❑ Fall <br />❑ Pass 0 Fail <br />Was sensor removed for testing? 0 Yes 0 No 0 NA <br />❑ Yes DNo ❑ NA <br />❑ Yes QNo ❑NA <br />0 Yes DNo DNA <br />Was sensor property replaced and ❑ yes ❑ No [INA <br />❑ Yes DNo DNA <br />0 Yes DNo 0 N <br />OYes ONo DNA <br />verified functional after testing? <br />Comments — (include Information on repairs made prior !o les -ling, and recontnrerzded follows-zrp for failed tests) <br />1 If the entire depth of the sump is not tested, specify how much was tested. If tlla answer to aM of the questions indicated with an <br />asterisk(*) is "NO" or "NA", the entire sump must be.tested. (See S WRCD LC -160) <br />
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