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INSTALL_2014 B100
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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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4 <br /> F. In-Tank Gauging/SIR Equipment: Check this box if tank gauging is used only for inventory control. <br /> ❑ Check this box if no tank gauging or SIR equipment is installed. <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. <br /> Complete the following checklist: <br /> ❑ Yes ❑ No* Has all input wiring been inspected for proper entry and termination,including testing for ground faults? <br /> C Yes ❑ No' Were all tank gauging probes visually inspected for damage and residue buildup? <br /> C Yes ❑ No` Was accuracy of system product level readings tested? <br /> 1 Yes L', No* Was accuracy of system water level readings tested? <br /> _1 Yes CI No* Were all probes reinstalled properly? <br /> 'iI Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> 'In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors(LLD): Q Check this box if LLDs are not installed. <br /> Com tete the following checklist: <br /> Cx Yes ❑ No* For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance? (Check all <br /> ❑ N/A that apply) Simulated leak rate:[j]3 g.p.h.;❑C 0.1 g.p.h ;[30.2 g.p.h. <br /> ❑r Yes ❑ No' Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> Lx Yes I No* Was the testing apparatus properly calibrated? <br /> f_y Yes i i No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ❑ N/A <br /> L Yes I I No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> C N/A <br /> ❑ Yes ❑ No' For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or <br /> ,k N/A disconnected? <br /> ❑ Yes i I No' For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or <br /> N N/A fails a test? <br /> C Yes C No* For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> Lx N/A <br /> '.x Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> *In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: <br /> e 1 <br /> APR 1 6 2914 <br /> ENVIRONMENTAL HEALTH <br /> DEPARTMENT <br /> Monitoring System Certification Page of 12/07 <br />
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