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INSTALL 1995
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231706
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INSTALL 1995
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Last modified
6/11/2019 3:37:18 PM
Creation date
4/10/2019 1:40:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
1995
RECORD_ID
PR0231706
PE
2361
FACILITY_ID
FA0000485
FACILITY_NAME
FLAG CITY CHEVRON
STREET_NUMBER
6421
STREET_NAME
CAPITOL
STREET_TYPE
AVE
City
LODI
Zip
95242
APN
05532024
CURRENT_STATUS
01
SITE_LOCATION
6421 CAPITOL AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
KBlackwell
Tags
EHD - Public
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75_ DTDTYG TYFnQ$tAT1nY <br />PIPING INFORMATION <br />TANK# <br />t* <br />Construction: <br />single -w Le- ailed, lined -trench, etc. <br />*'* <br />TANK# <br />Z <br />TANK# <br />TANK# <br />DISTANCE from <br />DISPENSER to TANK <br />26. <br />✓ <br />Piping (cross-sectional diagram, including connections to tank and dispensers). <br />MANUFACTURER <br />C/y /// /i?Q I-/ <br />SYSTEM TYPE * <br />o!r Al <br />CONSTRUCTION <br />L10*itf <br />MATERIAL <br />LEAK DETECTION SYSTEM <br />'S, %1J <br />100% METHANOL COMPATIBILITY with <br />FRP <br />�r <br />CORROSION PROTECTION <br />* <br />System Type; suction, pressure <br />t* <br />Construction: <br />single -w Le- ailed, lined -trench, etc. <br />*'* <br />Material <br />Type; steel -iron, s fiberglass, etc. <br />26. <br />✓ <br />Piping (cross-sectional diagram, including connections to tank and dispensers). <br />Double wall piping or _ Secondary containment (Trench liner, etc.) <br />�(1) <br />Product line (leak detector or automatic shut-off on <br />pressurized piping). <br />(2) Vent and vapor recovery Lines if not designed to <br />prevent the entrance of standing fluids. (Ball float valve) <br />(3) Manways and other single waited pipe fittings on a <br />double -walled tank, if not designed to prevent the <br />entrance of standing fluid. <br />27. <br />State Water Resources Control Board "Facility (A)" and "Tank Permit (B)" application forms submitted. <br />28. <br />Plan review and operating permit fees paid. <br />29. <br />Monitoring and Response Plans submitted. <br />30. <br />/ <br />Proof of financial responsibility on file. <br />' <br />31. <br />What is the approximate depth to ground water: <br />(include source of information - borehole logs, monitoring well data, water <br />studies, etc.) <br />32. <br />Total number of tanks on site after installation: T <br />33. <br />Any existing tanks to be removed or abandoned? YES DfI NO C ) If yes, submit State Water Resources <br />j <br />✓_ <br />Control Board "Facility Permit (B)" application form. <br />34. <br />Responsible party(ies) shall submit a "Letter of Commitment" prior to the <br />installation of new tanks. (Applies to sites with documented soil and/or groundwater contamination) <br />35. <br />./ County/City Fire District and Building Department notified. <br />36. <br />REMARKS <br />
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