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COMPLIANCE INFO 2017 - 2018
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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PR0231760
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COMPLIANCE INFO 2017 - 2018
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Entry Properties
Last modified
8/21/2019 11:07:05 AM
Creation date
8/21/2019 9:40:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2017 - 2018
RECORD_ID
PR0231760
PE
2351
FACILITY_ID
FA0003831
FACILITY_NAME
WATERLOO FOODMART
STREET_NUMBER
4315
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215-2305
APN
08710034
CURRENT_STATUS
01
SITE_LOCATION
4315 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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4315 E Waterloo Rd <br />04/18/18 <br />Designated operator monthly inspection report dated 8/25/17. <br />pc' c, <br />a) <br />ul t! <br />or <br />Ct <br />Aaron Hang, EHS <br />'100 -- <br />j1% <br />�t <br />\wow `0�jo <br />PR0231760 <br />PHOTO # <br />e <br />ROIINU STORAGE TANK SYSTEM FPORr <br />UNDERG LY INSPECTION R <br />DESIGNATED LIST OPERATOR MONTH <br />�' t„speciion pate: 8 /2 512 01 7 <br />117'"'1' Waterloo Shell <br />----- cit)': Stockton <br />4315 E. Waterloo Rd <br />Name of Ur n n.urd l Is'r Operator C'onductin” Inspection: Alex Jabbari pate: <br />gspiration 10/3/2018 <br />International t oda Council C'ertitication No.: 5243897 -UC phone: (925) 389-1262 <br />iiymaiure: <br />'tem MONITORING PANEL / ALARM HISI UK I <br />rt <br />is the monitorifEE <br />ed on and in ro ret o eratin2. Is the monitorinrrently showing any leak alarms? <br />is the Alarm Hitier the previous month available. and hs t - sienated USuc fr a co v uj tha alarm hislnrt' re tort) oQ to this ins eclton form. <br />1. Has each alarm for the previous month been responded to ap roriately? <br />UST SYSTEM INSPECTION <br />5. Are tank -top containment sumps free of water, debris, and hazardous substance? Note: !(the an,tiver to Item t was ")'es. or <br />':v I " sAip to item 6. Sumps trhere an alarm has occurred in the past month must he msperted should be attached +o ihtsnret�n has not responded <br />Sum Location: Sum Location: <br />Sum Location: Sum Location: <br />6. Are s ill buckets (containment structures) free of water, debris, and hazardous substance? <br />Yes No N/A <br />Tank I ID — Regular <br />Tank 3 ID — <br />Tank 2 ID — Premium Tank 4 ID — <br />7. Are under -dispenser containment areas free of water, debris, and hazardous substance? <br />Dispenser — I/2 <br />Dispenser - 3/4 <br />Dispenser - 5/6 <br />Dispenser - 7/8 <br />S. Leak detection is <br />located within <br />N/A <br />Dispenser - 9/10 <br />Dispenser - 11/12 <br />Dispenser - 13/14 <br />Dispenser -15/16 <br />containment. <br />NIA <br />NIA <br />Yes I No 1 NIA <br />EDis enser- 1/2 ® ❑ ❑ Dis enser-9110 ❑ ❑ Qqs enser - 3/4 Dispenser- t 1/12 <br />�,rM I F nisnencer— 13/14 <br />add <br />Page 17 of 36 <br />
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