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INSTALL_2014 B100
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0505264
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INSTALL_2014 B100
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Last modified
8/11/2021 11:07:34 AM
Creation date
11/5/2018 3:05:57 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
2014 B100
RECORD_ID
PR0505264
PE
2361
FACILITY_ID
FA0006672
FACILITY_NAME
FLYING J TRAVEL PLAZA #618*
STREET_NUMBER
1501
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
22811017
CURRENT_STATUS
01
SITE_LOCATION
1501 N JACK TONE RD
P_LOCATION
05
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\J\JACK TONE\1501\PR0505264\INSTALL FILE B100 2014.PDF
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EHD - Public
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XERXES TANK INSTALLATION CHECKLIST continued NY <br /> Tank Number Tank 41 Tank#2 Tank#3 Tank#4 <br /> A5.INSTALLATION continued(See SECTIONS 5,6, 7,8,9, 12 and 14 for instructions and specifications.) <br /> Anchor straps(f used) <br /> Geotextile(if used) - <br /> Backfill placement&compaction <br /> Ballasting(if wet hole) <br /> Fittings&other metal components _ <br /> (coated for corrosion protection) <br /> Depth of backfill over tank(specify) <br /> Level of backfill after final inspection <br /> Type and thickness of surface pad <br /> Piping connections per requirements <br /> A6.POSTINSTALLATION(See SECTIONS 13, 15 and 16 for instructions and specifications.) <br /> Postinstallaton tests for air-testabletanks <br /> Optional hydrostatic test <br /> Monitoring-fluid tanks(set fluid level _ <br /> when backfilling&top slab are complete, <br /> and record level in reservoir here) <br /> Monitoring-fluid tanks <br /> (verify there is no fluid inside tank) <br /> Containment sump <br /> (water test successful - <br /> A7.SITE SKETCH(Indicate specifics of tank installation.) AS.ADDITIONAL NOTES _ <br /> (including variations and/or deviations from <br /> instructions,with written authorizations attached) - <br /> Ag.VERIFYING SIGNATURES <br /> CONTRACTOR Name Date <br /> I verify that this information is a true record <br /> of the installation of the tanks listed here. <br /> Signature <br /> TANK OWNER/REPRESENTATIVE Name Date <br /> I verify that this information is a true record <br /> of the installation of the tanks listed here,and <br /> that I have received a copy of the Installation Signature <br /> Manual and this Tank Installation Checklist. <br /> © 2013 ZCL Composites Inc. XERXES www.xerxes.com <br /> a=company xi m c04/13 p p <br />
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