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COMPLIANCE INFO_2020
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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PR0231223
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
12/31/2020 8:09:56 AM
Creation date
5/19/2020 3:38:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0231223
PE
2361
FACILITY_ID
FA0002324
FACILITY_NAME
Pacific Service Station
STREET_NUMBER
6131
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
09746418
CURRENT_STATUS
01
SITE_LOCATION
6131 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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}£ ' 7 <br /> S D <br /> / y <br /> F. In-Tank Gauging 1 SIR Equipment: ® Check this box if tank gauging is used only for inventory con�rid I l j <br /> ❑ Check this box if no tank gauging or SIR equipment is installed . <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring . g ,, f R <br /> � 1 <br /> Complete the following checklist: t j 8 ` 1 iEAL rid <br /> ® Yes ❑ No* Has all input wiring been inspected for proper entry and termination , including testing for ground faults? <br /> ® Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> ® Yes ❑ No* Was accuracy of system product level readings tested? <br /> ® Yes ❑ No* Was accuracy of system water level readings tested? <br /> ® Yes ❑ No* Were all probes reinstalled properly? <br /> ® Yes ❑ No* Were all items on the equipment manufacturers maintenance checklist completed? <br /> * In Section H, below, describe how and when these deficiencies were or will be corrected. <br /> Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed . <br /> Complete the following checklist: <br /> ® Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) <br /> ❑ N/A Simulated leak rate: ® 3 g .p. h . ; ❑ 0. 1 g . p. h ; ❑ 0.2 g . p. h . <br /> ® Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> ® Yes ❑ No* Was the testing apparatus properly calibrated? <br /> ❑ Yes ❑ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br /> ® N/A <br /> ® Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br /> ❑ N/A <br /> ® Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br /> ❑ N/A <br /> ® Yes ❑ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br /> ❑ N/A <br /> ® Yes ❑ No* For electronic LLDs, have all accessible wiring connections been visually inspected? <br /> ❑ N/A <br /> ® Yes ❑ No* Were all items on the equipment manufacturers maintenance checklist completed ? <br /> * In Section H, below, describe how and when these deficiencies were or will be corrected . <br /> H . Comments : <br /> Monitoring System Certification Page 3 of 4 2/21 /07 <br />
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