COMPLIANCE INFO_2009-2018 - Laserfiche WebLink

Home Browse Search

MONIT ING SYSTEM CERTI ATION MAKE / MODEL OF MONITORING SYSTEM: Veeder-Root TLS -360 CERTIFICATION /TEST DATE: May 26, 2009 Al. FACILITY A2. OWNER Name Quik Stop Market #132 Nam* Quik Stop Markets, Inc. Address 3555 W. Hammer Lane, Stockton, CA 95219 Address 4567 Enterprise Street, Fremont, CA 94538 Phone # 510-657-8500 Phone # 810-857-8500 Contact Michael Karvelot Contact Michael Karvelot A3. C U P A A4. TESTING CONTRACTOR Name San Joaquin County Environmental Health Name Walton Engineering, Inc. Address 600 E. Main Street, Stockton, CA 95202 Address P.O. Box 1023, W. Sacramento, CA 95691 Notified May 18, 2009 Lic # 617238 A, B, Haz Inspector Garrett Backus Contact Richard Walton Phone # 209.468-3439 Phone # 918-825.3203 B. INVENTORY OF EQUIPMENT TESTED/CERTIFIED (check the appropriate boxes to Indicate equipment inspect*dlservicsd) 131: TANKS Tank #1 (Product): Gasoline - 87 Tank #2 (Product): Gasoline - 89 ❑ In -Tank Gauging Probe Model: ❑ In -Tank Gauging Probe Model: ■ Annular Space or Vault Sensor Model: 0794390409 ■ Annular Space or Vault Sensor Model: 0794390409 ■ Piping Sump I Trench Sensor(s) Model: 0784390-209 ■ Piping Sump I Trench Sensors) Model: 0794380-M ❑ Fill Sump Sensor(s) Model: ❑ Fill Sump Sensors) Model: ■ Mechanical Line Leak Detector Model: VMI 99LD-2000 ■ Mechanical Line Leak Detector Model: VMI 98LD-2000 ❑ Electronic Line Leak Detector Model: ❑ Electronic Lin* Leak Detector Model: ❑ Tank Overfill I High -Level Sensor Model: ❑ Tank Overfill I High -Level Sensor Model: ❑ Other (specify equipment in Section E) Model: ❑ Otte (specify equipment in Section E) Model: Tank #3 (Product): Gasoline - 91 j` Tank #4 (Product): _ r ❑ In -Tank Gauging Probe Model: E ❑ In -Tank Gauging Probe Model: ■ Annular Space or Vault Sensor Model: 0784380409 ❑ Annular Space or Vault Sensor Model: ■ Piping Sump I Trench Sensor(s) Model: 0794390-209 ❑ Piping Sump I Trench Sensor(s) Model: ❑ Fill Sump Sensor(s) Model: ❑ Fill Sump Sensor(s) Model: ■ Mechanical Line Leak Detector Model: FE Petro STP -MLD ❑ Mechanical Line Leak Detector Model: ❑ Electronic Line Leak Detector Model: ❑ Electronic Line Leak Detector Model: ❑ Tank Overfill I High -Level Sensor Model: ❑ Tank Overfill I High -Level Sensor Model: ❑ other (specify equipment in Section E) Model: ❑ Other (specify equipment in Section E) Model: B2: DISPENSERS/UDC's Dispenser # : 1-2 ■ Dispenser Containment Sensor(s) Model: 0794390-2W ■ Shear Valves ❑ Dispenser Containment Float(s) and Chain(s) Dispenser ■ Dispenser Containment Sensor(s) Model: 0794390-208 ■ Shear Valves ❑ Dispenser Containment Floats) and Chains) Dispenser # ❑ Dispenser Containment Sensor(s) Model: ❑ Show Valves ❑ Dispenser Containment Float(s) and Chaln(s) Dispenser # : 3.4 ■ Dispenser Containment Sensors) Model: 0794380-209 ■ Shear Valves ❑ Dispenser Containment Ftoags) and Chain(s) Dispenser # : 7-8 ■ Dispenser Containment Sensor(s) ■ Shear Valves ❑ Dispenser Containment Floats) and Dispenser # ❑ Dispenser Containment Sensor(s) ❑ Shear Valves ❑ Disperser Containment Float(s) and C. CERTIFICATION 1 ce ft that the equipmat identified in this document vas in accordance with the nwndaeauws' guireanes. Attached to this CertiRcntlon is Information (e.g. manufactures' checkihft) necessary to verity that this information is correct and a Plot Pian showig the layout of monitoring equipment. For any equipment capable of generating such reports, l have also attached a copy of the report, (chock as that apply): ■ system set7vp ■ Alarm History Report Signature: � ' . W,0= WLLTOII ENGINEERING, INC. Technician I Cert #: Jessie YWdldn s 1836391 53076864JT Date: May 26, 2W9