COMPLIANCE INFO_1999-2010 - Laserfiche WebLink

Home Browse Search

May 25 06 03:15p Mike Dotten 209-533-2650 p.1 AlItecht 17759 Buttercup Circle, Sonora, CA 95370 Phone: 209-532-7320; Fax: 209-533-2650 California Contractor 623541 A-Haz Mike@AlltechPetro.com MONITORING SYSTEM CERTIFICATION 1j A. General Information Facility Name:Hammer I-5 Arco Date of Testing/Servicing:January 5,2006 Facility Address:3250 Hammer Lane,Stockton CA 95249 Facility Contact Penson:Wes Parkinson Contact Phone No.:474-9125 Regulatory agency:San Joaquin Health;Inspector:Michelle;Phone:468-9847;Fax 468-3433 MakeiModel of Monitoring System: Veeder-Root TLS-350 This test report is a: M Final Report(Facility was observed to be in Compliance)or a❑Preliminary Report(Unresolved Issues Exist) B. Invents of E ni ment Tested/Certified: Tank ID:Regular Master Tank ID:Regular Skave ®In-Tank Gauging Probe. Model:Mag 1 ®In-Tank Gauging Probe. Model:Mag 1 ®Annular Space or Vault Sensor. Model: Brine ®Annular Space or Vault Sensor. Model:Brine ®Piping Sump Sensor(s). Model:Float Switch ®Piping Sump Sensor(s). Model:Float Switch ❑Fill Sump Sensor(s). Model:NONE ❑Fill Sump Sensor(s). Model:NONE ®Mechanical Line Leak Detector. Model:Red Jacket I Mechanical Line Leak Detector. Model:Red Jacket ❑Electronic Line Leak Detector. Model:NONE ❑Electronic Line Leak Detector. Model:NONE ®Tank Overfill/High-Level Sensor. Model:Drop Tube CK Tank Overfill I High-Level Sensor. Model:Drop Tube ®Fills ill buckets tested ®Pass ❑Fail 0 Fills ill buckets tested ®Pass ❑Fail Tank ID:Premium Tank ID: ®In-Tank Gauging Probe. Model:Mag 1 ❑In-Tank Gauging Probe. Model: ®Annular Space or Vault Sensor. Model:Brine ❑Annular Space or Vault Sensor. Model: ®Piping Sump Sensor(s). Model:Float Switch ❑Piping Sump Sensor(s). Model: ❑Fill Sump Sensor(s). Model:NONE ❑Fill Sump Sensor(s). Model: ®Mechanical Line Leak Detector. Model:Red Jacket ❑Mechanical Line Leak Detector. Model: ❑Electronic Line Leak Detector. Model:NONE ❑Electronic Line Leak Detector. Model: ®Tank Overfill/High-Level Sensor. Model:Drop Tube ❑Tank Overfill/High-Level Sensor. Model: ®Fills ill buckets tested ®Pass ❑Fail ❑Fills ill buckets tested ❑Pass []Fail Dispenser ID:1&2®Sump:®Dry❑Water❑Product Dispenser ID:3&4®Sump:®Dry❑Water❑Product ❑Dispenser Containment Sensor(s). Model:Bravo Box ❑Dispenser Containment Sensor(s). Model:Bravo Box M Shear Valve(s) (Functional test) ®Shear Valve(s) (Functional test) ®Dispenser Containment Floats and Chain(s). M Dispenser Containment Float(9 and Chain s). Dispenser ID:5&6 M Sump:®Dry❑Water❑Product Dispenser ID: 7&8®Sump:®Dry❑Water❑Product ❑Dispenser Containment Sensor(s). Model:Bravo Box ❑Dispenser Containment Sensor(s). Madel:Bravo Box M Shear Valve(s) (Functional test) ®Shear Valve(s) (Functional test) M Dispenser Containment Floats and Chains . M Dis cnser Containment Float(s)and Chains. Dispenser ID: ❑Sump:❑Dry❑Water❑Product Dispenser ID: ❑Sump: [--]Dry❑Water❑Product ❑Dispenser Containment Sensor(s). Model: ❑Dispenser Containment Sensor(s). Model: ❑Shear Valve(s) (Functional test) ❑Shear Valve(s) (Functional test) ❑Dispenser Containment Float s)and Chains. ❑Dis eraser Containment Floats and Chain s). C. Certification-I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports,I have also attached a copy of th report;(eheck all Chad apply): ®System set-up ®Alarm history report Technician: Mike Dotten,California Contractor License.No.: 623541 Certification: Veeder-Root:341-32-6743;Level 4. ICC UST Technician#5259412-UT Page 1 of 3 03/01