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COMPLIANCE INFO 2017 - 2018
EnvironmentalHealth
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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 inspection report dated 3/5/18. <br />PR0231760 <br />PHOTO # <br />I N1)V11GU 1 N1) S'F0 RA(.F,'FA NK SYS'1'F'M <br />I21 IC:N' t"i ('11 i "; t c 1t'� 1%'A' 0R MONT111,ti' INtii'1 (• V1()N RVA1 M, <br />LV=icihi . \amc: Waterloo Suer'! Inspection Date: 3/5/2018 , <br />- -- <br />acilit% Address: 4315 E. Waterloo Rd — -- Cit\ Stockton <br />j, \'ame ot-[)esi ,hated I 'ST Operator Conducting Inspection Alex ,lahhari <br />International Code Council Certification No.: 524389 -/-UC I l:xhiration Datc: 10/3/2018 <br />* Signature: <br />( 925) 389-1262_ <br />Ro� <br />)tem ; MONUFORING PANEL / ALARM HISTORY ^ <br />1. 1 Is tho tnonitorin,T s�stmi pottered on and in propLr c)p�:ratlno nlode?Is the monitoring, sxstem not currently showim, ani leaf. alanns? <br />is the Alarm Histor- Report%lo > for the previous month available. and has it been reviewed by the <br />_ Desiunated UST Operator? (Attach a cont.• of clic alarm history reporillog to this inspection farm. ) <br />4. Has each alarm for the previous month been responded to appropriately? � ®� ❑ � ❑ <br />UST SYSTEM INSPECTION <br />5. Are tank -top containment sumps free of water, debris, and harardou-, substance? Note Ifthc amN•er to Item a was "Yes, <br />"AA - skip to Rem 6. Sumps inhere an alarm has occurred in the past month must he. inspected if a qualified service technician has not responded <br />to, and ro rh, addressed, the cause o the alarm. Documentation veri in appropriate service should he attached to this re rt. <br />Yes No Yes No <br />Sump Location: LJ <br />U Sump Location: u <br />U U I' <br />Sum Location:F1 <br />Sump Location: <br />6. Ares ill buckets (containment structures) free of water, debris, and hazardous substance? <br />Yes <br />No N/A <br />Yes No NIA r <br />Tank 1 ID – Regular 11,21 <br />❑ 1 ❑ Tank 3 ID – <br />` ❑ I �' <br />Tank 2 ID – Premium ® <br />❑ El 4 ID – <br />Are under -dispenser containment areas free of water, debris, and hazardous substance? <br />� <br />— <br />Yes <br />No I N/A <br />No i NIA <br />Aaron Hang, EHS <br />Page 33 of 36 <br />
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