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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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PR0527026
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BILLING_PRE 2019
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Entry Properties
Last modified
4/28/2021 11:40:43 AM
Creation date
11/5/2018 12:57:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0527026
PE
2361
FACILITY_ID
FA0018313
FACILITY_NAME
JOES TRAVEL PLAZA
STREET_NUMBER
15688
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
LATHROP
Zip
95330
APN
19620077
CURRENT_STATUS
02
SITE_LOCATION
15688 S HARLAN RD
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\H\HARLAN\15688\PR0527026\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
5/14/2013 8:00:00 AM
QuestysRecordID
159488
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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04/17/2007 09:24 916-373-1172 WALTON ENGINEERTNGpp 06 <br /> "I 4q,�4GMI'`� <br /> UNIFEED PROGRAM CONSOLEDATED FORM <br /> TANKS ✓q l I w <br /> UNDERGROUND STORAGE TANKS - TANK PAGE 2 <br /> VI: IPI{VG'EOxSTRUCTTfIN:'eikek'hnaMla Paze 2o1`2 <br /> UNDERGROUND PIPING ABOVEGROUND PIPING <br /> SYSTEM TYPE 0 1.PRESSURE 0 2.SUCTION ❑3.GRAVITY 159. 0 1.PRESSURE 0 2.SUCTION 0 3.GRAVITY 419, <br /> CONSTRUCTION, 0 I.SINOU:WALL 0 3.LINED TRENCH 0 99,OTHER 4an, 0 I.8INOLE WALL <br /> MANUFACTURER 0 2.DOUBLE WALL 0 95.UNKNOWN C3 9S.UNKNOWN n65. <br /> ❑Z.DOUBLE WALL 079.OTHhR <br /> RER <br /> MANUFACTURER U131OtOWn 461 MANUFACTURER 463, <br /> M I.BARE STEEL 13 6,FRP COMPATIBLE..W/10091 METHANOL 111-BARE STEEL. 0 6.FRP COMPATIBLE W/100%METHANOL <br /> C 2.STAINLESS STEEL 0 7.GALVANIZED STEEL C 2.STAINLESS STEEL <br /> ❑7.GALVANIZED STEEL,. <br /> C t,PLASTIC COMPATIBLE WITH CONTENTS 0 95,UNKNOWN 0 3,PLASTIC COMPATIBLE W/CONTENTS 0 S.FLEXIBLE(HDPE) 0 99.OTHER <br /> 0 4.FIBERGLASS ❑8 FLEXIBLE(HDFB) 0 99.OTHER Q 4.FIBERGLASS 0 9.CATHODIC PROTECTION <br /> 0 5.STEEL W/COATING [19.CATHODIC PROTECTION 464. D 5,STEEL W/COATING <br /> C7 95.UNKNOWN 465, <br /> 7WALLLL PIPING UNDERGROUND PIPINGqbb. 91NGLE WALL PIPIN[L PIP :A.EeYlEt17, ON" YII' 'aii a6hbtIheG 469PIPING(Check all thniapply): PRESSURIZED PIPING(Check all thatapply): <br /> ONIC LINE LEAK DETECTOR 3.0 GPH TEST tlMU AUTO PUMP 01. ELECTRONIC LINE LEAK DETECTOR 3.0 GPM TEST 3iATFl AUTO PUMP <br /> FF FOR LEAK SYSTEM FAILURE,AND SYSTEM DISCONNECTION SHUT OFF FOR LEAK,SYSTEM FAILURE,AND SYSTEM DISCONNECTION <br /> LE AND VISUAL ALARMS, r AUDIBLE AND VISUAL ALARMS. <br /> LY 0.2 GPH TEST ❑2, MONTHLY 0.2 GPH TEST <br /> L INTEGRITY TEST(0,1 OPH) 03, ANNUAL INTEGRITY TEST(O.I GPM) <br /> [14. DAILY VISUAL CHECK <br /> CONVENTIONAL SUCTION SVRTEMS CONVENTIONAL SUCTION SYSTEMS(Check nil that apply) <br /> 0 S. DAILY VISUAL MONITORINO OF PUMPING SYSTEM+TRIENNIAL PIPING <br /> INTEGRITY TEST(0.1 GPM) 0 S DAILY VISUAL,MONITORING OF PIPMO AND PUMPING SYSTEM <br /> SAPP,SUCTION SYSTEMS(NO VALVES IN BELOW GROUND PIPMG): 06. TRIENNIAL INTEGRITY TEST(0.1 GPM) <br /> 0 7, SELF MONITORING SAFE SUCTION SYSTEMS MO VALVES M BELOW GROUND PIPING): <br /> GRAVITY FLOW 07. SEI.F MONITORING <br /> 09, BIENNIAL INTEGRITY TEST(O,I GPM) GRAVITY FLOW(Check all flint apply)'. <br /> [18. DAILY VISUAL MONITORING <br /> 09, BIENNIAL INTEGRITY TEST(0.I GPM) <br /> SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING <br /> PR1IRRVRIZED PIPING(Check all that apply); PRESSURIZED PIPING(Check all then apply): <br /> 10. CONTINUOUS TURBINE SUMP SENSOR 3M AUDIBLE AND VISUAL 10, CONTINUOUS TURBINE, SUMP SENSOR WITH AUDIBLE AND VISUAL <br /> ALARMS AND(Check one) ALARMS AND(Check one) <br /> ❑ <br /> P. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS 0 a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS <br /> ❑b. AUTO PUMP SHUT OFF FOR LEAKS,SYSTEM FAILIJRIi AND SYSTEM 0 b. AUTO PUMP SMUT OFF EOR LEAKS,SYSTEM FAILURE AND SYSTEM <br /> DISCONNECTION DISCONNECTION <br /> De. NO AUTO PUMP SHUT OFF. Dc, NO AUTO PUMP SHUT OFF <br /> 0 11. AUTOMATIC LINE LEAK DETECTOR(3,0 GPM TEST) FI FLOW SHUT 0 11. AUTOMATIC LEAK DETECTOR <br /> OFF OR RESTRICTION <br /> 0 12, ANNUAL INTEGRITY TEST(0.1 GPH) 0 12.ANNUAL INTEGRITY TEST(0.1 GPH) <br /> SUCTION/GRAVITY SYSTEM SUCTION/GRAVITV SVSTRM <br /> CIA, CONTINUOUS SUMP SENSOR AUDIBLE AND VISUAL ALARMS 013.CONTINUOUS SUMP SENSOR AUDIEI.E AND VISUAL ALARMS <br /> EMERGENCY GENERATORS ONLY(Check all thnl IPPIY) EMERGENCY GENERATORS ONLY(Clmek all Mal apply) <br /> 014. CONTINUOUS SUMP SENSORI P=AUTO PUMP SHUT OFF 014.CONTINUOUS SUMP SENSOR N'1THOUt AUTO PUMP SHUT OFF <br /> AUDIBLE AND VISUAL ALARMS AUDIBLE AND VISUAL-ALARMS <br /> CIS. AUTOMATIC LME LEAK DETECTOR (3.0 GPM TEST) TWLHOUT FLOW 013 AUTOMATIC LINE LEAK DETECTOR(3.0GPM TEST) <br /> SHAT OFF OR RESTRICTION <br /> 16. ANNUAL INTEGRITY TEST(0.I GPM) 0 16, ANNUAL INTEGRITY TEST(0,1 GPH) <br /> D n, DAILY VISUAL CHECK [117.DAILY VISUAL CHECK <br /> .. . VULD79$ENSEMLIOVTAINM1:NT <br /> DISPENSER CONTAINMENT 460. 01. FLOAT MECHANISM THAT SHIM OFF SHEAR VALVE 04. DAILY VISUAL CMECK 464, <br /> DATE INSTALLED 02. CONTINUOUS DISPF„NSER PAN SENSOR+AUDIBLE AND VISUAL ALARMS 05. TRENCH/LINER MONITORING <br /> 03. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT CFF FOR <br /> N/A DISPENSER+AUDIBLE AND VISUAL ALARMS [36. NONE <br /> ;;. I i �'Cl'iYFVtSPTOYY(SICYVMI'CdRR <br /> I certify that the'nfrnmation tovided herein is true and a urate to the bat of my knowledge. <br /> SIGNATURE OT .P TOR DATE;4/16/07 - q'" <br /> NAME.OF 04ERMPERAT6R IMO: Michael E. Wal OR TITLE OF OWNER/OPERATGR; Contractor 472' <br /> P6nni1 Number(Apcney tue only) 479. Pcnnit Approved By(Agency osc only) 474 1 Pmnit Expiration Date(Agency aeo only) 471. <br /> UPCF hwlWmb(1199)-3/4 httpWwww.RRidnea.nrg Rev.02/16M <br />
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