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BILLING_PRE 2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0516736
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BILLING_PRE 2019
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Entry Properties
Last modified
1/4/2023 4:19:21 PM
Creation date
11/2/2018 6:50:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0516736
PE
2361
FACILITY_ID
FA0012764
FACILITY_NAME
SAFEWAY FUEL CENTER #1769
STREET_NUMBER
2802
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
CURRENT_STATUS
01
SITE_LOCATION
2802 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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\MIGRATIONS\C\COUNTRY CLUB\2802\PR0516736\BILLING 2001-2006.PDF
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EHD - Public
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1 <br /> TANK 2A <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> UNDERGROUND STORAGE TANKS - TANK PAGE 2 TANKS <br /> VL PIPING CONSTRUCTION Chnk pl thata <br /> UNDERGROUND PIPING rage ofABOVEGROUND PIPING <br /> SYSTEM TYPE ;7 L PRESSURE ❑2.SUCTION 0 3.GRAVITY 454 0 I.PRESSURE 0 2. SUCTION 1013.GRAVITY 459 <br /> CONSTRUCTION 0 L SINGLE WALL 01-1-.- - . 0.1.SINGLE WALL 0 95.UNKNOWN <br /> MANUFACDIRER 10 2.DOUBLE WALL 0 95.UNKNOWN 0 2.DOUBLE WALL <br /> ❑99.OTHER <br /> MANUFACTURER_ 4il MANUFACTURER_ 463 <br /> D I.BARE STEEL 0 6.FRP COMPATIBLE w/Iarb MEDIANDL 0 1.BARE STEEL 0 6.FRP COMPATIBLE Wn9ox�NOL <br /> }0 2.STAINLESS STEEL 0 7.GALVANIZED STEEL 0 UNmowe 0 2. STAINLESS STEEL 0 7.GALVANIZED STEEL <br /> E?3.PLASTIC COMPATIBLE W/CONTENTS 099. Other 03. PLASTIC COMPATIBLE W/CONTENTS 08.FLEXIBLE(HDPE) 099. OTHER <br /> 04.FIBERGLASS 08:FLEXIBLE(HOPE) 04. FIBERGLASS 09.CATHODIC PROTECTION <br /> 0 5.STEEL W/COATING 0 9.CATHODIC PROTECTION 464 D 5. STEEL W/COATING <br /> ❑95.UNKNOWN 465 <br /> VIL PIPING LEAK DETEC[fON Chwtall0ua Ae nofthaia aiin shallbe submitted mthe locale _) <br /> UNDERGROUND PIPING ABOVEGROUND PIPING <br /> SRVGLE WALL PIPING 466. SINGLE WALL PIPING 467 <br /> PRESSURIZED PIPING(Ch«k au thin apvy): PRESSURIZED PIPING(Cha*atl Nstapply): <br /> 0 I.ELECTRONIC LINE LEAK DETECTOR 3 0 GPH TEST WITH AUTO PUMP SHUT 0 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP <br /> OFF FOR LEAK;SYSTEM FAILURE,AND SYSTEM DISCONNECTION+ SHUT OFF FOR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION+ <br /> AUDIBLE AND VISUAL ALARMS. AUDIBLE AND VISUAL ALARMS. <br /> 0 2.MONTHLY 0.2 GPH TEST 02. MONTHLY 0.2 GPH TEST <br /> D 3.ANNUAL INTEGRITY TEST(0.IGPM 0 3.ANNUAL INTEGRITY TEST(O.IGPM <br /> 0 4. DAILY VISUAL CHECK <br /> CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS(Cha:k all eat appy) <br /> 0 5.DAILY VISUAL MONITORING OF PUMPING SYSTEM+TRIENNIAL PIPING <br /> INTEGRITY TEST(0.1 GPH) D 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM <br /> SAFE SUCTION SYSTEMS(NO VALUES IN BELOW GROUNDPIPING): 0 6. TRIENNIAL INTEGRITY TEST(0.1 GPH) <br /> 0 7.SELF MONITORING SAFE SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPING): <br /> GRAVITY FLOW 0 7. SELF MONITORING <br /> 0 9.BIENNIAL INTEGRITY TEST(01 GPH) GRAVITY FLOW(Chink ad a ist Vpy): <br /> 08. DAILY VISUAL MONITORING <br /> 09. BIENNIAL INTEGRITY TEST(0.1 GPH) <br /> SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING <br /> PRESSURIZED PIPING(Check all that apply): PRESSURIZED PIPING(Cbak41 thatappyp <br /> 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL <br /> }}AA�LARMS AND(Chak one) ALARMS AND(Ch k one) <br /> L a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS 0 a AUTO.PUMP SHUT OFF WHEN A LEAK OCCURS <br /> 0 b. AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM 0 b AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILURE AND SYSTEM <br /> DISCONNECTION DISCONNECTION <br /> Dc NO AUTO PUMP SHUT OFF 0. NO AUTO PUMP SHUT OFF <br /> ❑II. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITH FLOW SHUT <br /> OFF OR RESTRICTION 011 AUTOMATIC LEAK DETECTOR <br /> 0 12. ANNUAL INTEGRITY TEST(0.1 GPH) 0 12. ANNUAL INTEGRITY TEST(0.1 GPH) <br /> SUCTION/GRAVITY SYSTEM SUCTION/GRAVITY SYSTEM <br /> 013. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL.ALARMS 013.CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS <br /> EMERGENCY GENERATORS ONLY(ChiaA aH that apply) EMERGENCY GENERATORS ONLY(Check all list appy) <br /> D 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP S14UT OFF• 0 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF <br /> AUDIBLE AND VISUAL ALARMS AUDIBLE AND VISUAL ALARMS <br /> 0 15. AUTOMATIC LINE LEAK DETECTOR(3.0 GPH TEST)WITHOUT FLOW 0 I5. AUTOMATIC LINE LEAK DETECTOR(3.0 GPHTEST <br /> SHUT OFF OR RESTRICTION ) <br /> 0 16.ANNUAL INTEGRITY TEST(0.1 GPH) 0 16.ANNUAL INTEGRITY TEST(0.1 GPH) <br /> 017. DAILY VISUAL CHECK D 17. DAILY VISUAL CHECK <br /> VOL DISPENSER CONTAINMENT <br /> DISPENSER CONTAINMENT 0 1.FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE 04.DAILY VISUAL CHECK <br /> DATE INSTALLED 468 F 2.CONTINUOUS DISPENSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS 0 5.TRENCH LINER/MONITORING <br /> 2001 )M 3.CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR D 6.NONE 469 <br /> DISPENSER+AUDIBLE AND VISUAL ALARMS <br /> UC.OWINEWOPERATOR SIGNATURE <br /> I on*that &n provided herein is We and accurate w the bap ofmy knowledge. <br /> A <br /> F O E DATE 4A <br /> 1ZA.R pnua) 471 TITLE O R/OPERATOR 9T1 LEE PROJECT MANAGER <br /> rb usconly) 47I Pamh Appr (F.kraal useo ly) 474 Pam'a Eapiradon Deae(Forlaalummly) 475 <br /> \110, Iw/ <br />
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