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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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PR0231356
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BILLING_PRE 2019
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Entry Properties
Last modified
12/12/2023 1:07:04 PM
Creation date
11/5/2018 5:52:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0231356
PE
2361
FACILITY_ID
FA0003815
FACILITY_NAME
TESORO (MOBIL) 68154
STREET_NUMBER
2500
Direction
W
STREET_NAME
LODI
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
02740006
CURRENT_STATUS
01
SITE_LOCATION
2500 W LODI AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\L\LODI\2500\PR0231356\BILLING 1985-1997.PDF
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EHD - Public
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PROGRAM CONSOLIDATED <br />YV\N <br />UNDERGROUND STORAGE TANKS - TANK PAGE 2 <br />VI. PIPING CONSTRUCTIONcall uftte 1 page of <br />UNDERGROUND PIPING ABOVEGROUND PIPING <br />SYSTEMTYPE ® 1. PRESSURE D 2. SUCTION D 3. GRAVITY 4% ❑ 1. PRESSURE D 2. SUCTION D 3. GRAVITY 459 <br />CoNSIRUCnoN [11. SINGLE WALL D 3. LINED TRENCH D 99. OTHER 460 ❑ 1. SINGLE WALL D 95. UNKNOWN 462 <br />MANUPACTURER ® 2. DOUBLE WALL D 95. UNKNOWN ❑ 2. DOUBLE WALL [199. OTHER <br />MANUFACTURER ENVIRON 461 MANUFACTURER 463 <br />❑ 1. BARE STEEL D 6. FRP COMPATIBLE w/100% METHANOL ❑ 1. BARE STEEL Cl 6. FRP COMPATIBLE W/100% METHANOL <br />D 2. STAINLESS STEEL D 7. GALVANIZED STEEL I DUnknown 12 STAINLESS STEEL D 7. GALVANIZED STEEL <br />[13. PLASTIC COMPATIBLE W/ CONTENTS D 99. Otho ❑ 3. PLASTIC COMPATIBLE W/ CONTENTS D S. FLEX03LE (HOPE) [199. OTHER <br />[14. FIBERGLASS N S. FLEXIBLE (HDPE) ❑ 4. FIBERGLASS D 9. CATHODIC PROTECTION <br />D 5. STEEL W/COATING D 9. CATHODIC PROTECTION 464 D 5. STEEL W/COATING ❑ 95. UNKNOWN 465 <br />SINGLE WALL PIPING 466 <br />PRESSURIZED PIPING (Checkall d tapply): <br />❑ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT <br />OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION+ <br />AUDIBLE AND VISUAL ALARMS. <br />D 2. MONTHLY 0.2 GPH TEST <br />D 3. ANNUAL INTEGRITY TEST (0.1GPH) <br />CONVENTIONAL SUCTION SYSTEMS <br />D 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM+ TRIENNIAL PIPING <br />INTEGRITY TEST (0.1 GPH) <br />SAFE SUCTION SYSTEMS (NO VALUES IN BELOW GROUNDPIPING): <br />D 7. SELF MONITORING <br />GRAVITY FLOW <br />D 9. BIENNIAL INTEGRITY TEST (0.1 GPH) <br />SECONDARILY CONTAINED PIPING <br />PRESSURIZED PIPING (Check all 0ut apply): <br />10. CONTINUOUS TURBINE SUMP SENSOR AUDIBLE AND VISUAL <br />ALARMS AND (Check one) <br />❑ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS <br />® b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM <br />DISCONNECTION <br />Oc. NO AUTO PUMP SHUT OFF <br />❑ 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHFLOW SHUT <br />OFF OR RESTRICTION <br />D 12. ANNUAL INTEGRITY TEST (0.1 GPH) <br />SUCTION/GRAVITY SYSTEM <br />D 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS <br />EMERGENCY GENERATORS ONLY (Check all that apply) <br />❑ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF <br />AUDIBLE AND VISUAL ALARMS <br />D 15, AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW <br />SHUT OFF OR RESTRICTION <br />❑ 16. ANNUAL INTEGRITY TEST (0.1 GPH) <br />❑ 17. DAILY VISUAL CHECK <br />SINGLE WALL PIPING 467 <br />PRESSURIZED PIPING (Chwkall that apply): <br />❑ <br />I. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP <br />SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION i <br />AUDIBLE AND VISUAL ALARMS. <br />D 2. MONTHLY 0.2 GPH TEST <br />D 3. ANNUAL INTEGRITY TEST (0.1 GPH) <br />[14 DAILY VISUAL CHECK <br />CONVENTIONAL SUCTION SYSTEMS (Check all ftt apply) <br />D 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM <br />D 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) <br />SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): <br />D7. SELF MONITORING <br />GRAVITY FLOW (CheckaE that apply): <br />D S. DAILY VISUAL MONITORING <br />D 9. BIENNIAL INTEGRITY TEST (0.1 GPH) <br />SECONDARILY CONTAINED PIPING <br />PRESSURIZED PIPING (Check all that apply): <br />10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL <br />ALARMS AND (Check one) <br />D a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS <br />D b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEMFAILURE AND SYSTEM <br />DISCONNECTION <br />Oc NO AUTO PUMP SHUT OFF <br />D 11. AUTOMATIC LEAK DETECTOR <br />[112. ANNUAL INTEGRITY TEST (0.1 GPH) <br />SUCTION/GRAVITY SYSTEM <br />D 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS <br />EMERGENCY GENERATORS ONLY (Check all that apply) <br />D 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF <br />AUDIBLE AND VISUAL ALARMS <br />D 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) <br />[116. ANNUAL INTEGRITY TEST (0.1 GPH) <br />D 17. DAILY VISUAL CHECK <br />VIII. DISPENSER CONTAINMENT <br />DISPENSER CONTAINMENT ® 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ❑ 4. DAILY VISUAL CHECK <br />DATE INSTALLED 461 D 2. CONTINUOUS DISPENSER PAN SENSOR+ AUDIBLE AND VISUAL ALARMS ❑ 5. TRENCH LINER / MONITORING <br />1997 D 3. CONTINUOUS DISPENSER PAN SENSOR W31' AUTO SHUT OFF FOR D 6. NONE 469 <br />DISPENSER + AUDIBLE AND VISUAL ALARMS <br />IX. OWNER/OPERATOR SIGNATURE <br />I cat fly theifummdonprovided heam u true and azcmate a ofmyknowltdge. <br />SIGNATURE OF OWNER/OPERATOR 11 DATE to �` ( O ( 470 <br />OF <br />UPCF <br />revised) <br />TITLE <br />O a�:T0 <br />Formerly SWRCB Form B <br />
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