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COMPLIANCE INFO_1999-2010
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0232224
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COMPLIANCE INFO_1999-2010
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Last modified
4/7/2021 10:42:38 AM
Creation date
6/3/2020 9:56:35 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1999-2010
RECORD_ID
PR0232224
PE
2361
FACILITY_ID
FA0001877
FACILITY_NAME
AM PM HAMMER/I5 FOOD #83113
STREET_NUMBER
3250
Direction
W
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95209
APN
08240009
CURRENT_STATUS
01
SITE_LOCATION
3250 W HAMMER LN
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0232224_3250 W HAMMER_1999-2010.tif
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EHD - Public
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I/-42/1995 03:27 2097546722 CALAVERAS ENV.1 EAL7fi PAGE 02 <br /> vlotsiloring System Certiftestion <br /> Fxsfity Name: i /"a^.t_l J73 IZZ Drec ut i csUng;acrvsc tng:/2 /Olet <br /> D. Results of Testing/Servicing <br /> Co fete the AMortur checklist: <br /> Gl No• Is the M=ItOring system OPeratiOnAl-Rct manufacturer'sspecifications-? <br /> MrXcs O No' Is the audible atarm tionil? <br /> es 11 No; is the visual alarm o ational? <br /> Or <br /> Yes 13 NO* Were all aessasots visually inspected.tested and confirmed operational? <br /> Z,Ycs 0 No® Were all sensors and pMbes reinstalled f cr) ? . <br /> es O No• Is 0 tnonitoris: a ui must secured from uaassthorizcd <br /> IN Yes ® Woo If alanus we relayed to a remote tnotaitoriny station, is ail communications equipment (e.g. rrtodeni) <br /> N/A operat--r <br /> Yes II No" If needed by any monitoring equipment,are replacement fuzes and/or batteries available? <br /> G NVA <br /> O Ycs O No' For pressurized piping systetsts,does the turbine automatically shut down if the piping secondary containment <br /> ® NIA monitoring systems detects a leak,fails to ope�rafry�ro°r is electrically disconnected? If yes: which sensors initiate <br /> E <br /> positive shut-down? (Check all that apply) Sumprrrench Sensors; O Dispenserc�tnrrrent Sensors. <br /> Did you confirm positive Shur-down due to leaks its senior failurt/disconaeetion? iilXes; O No- <br /> yes O No• For nsonnarieng systems that also serve as tank overfill warning devices, is the overfill warning alarm visible <br /> O N/A and audible at the rank fill point(s)and operating properly? If so. at what pareent of tank capacity docs the <br /> alarm Witter? % <br /> Q Yes' UrNo Was any monitoring equipment replaced? If yes,identify specific sensors,probes,or other equipment replaced <br /> and list the manufacturer name and model for all r92L3Ecmcnt Pam in Section E below. <br /> Q <br /> As No Was my system software adcd? If yes.identify tha new version number in Section E.Me o-. <br /> Ycs• Q No Was liquid found inside any secondary containment systems? (Check all roar apply)CI Product; wateriii <br /> YM describe causes in section E.below. <br /> *In Section E below,describe how and when these deficiencies were or wilt be corrected. <br /> E. Comments:_ f <br /> Page 3 0£this Certification must be completed and attached only if one or more of the following condhimu are met: 1.)fa- <br /> tank gauging equipment b used to perform leak detection monitoring; 2.)Linc leak detectors are installed on p[Ping systems: <br /> 3.)Completion is required by your-local agency that regulates UST systems. <br /> C,LLnr.®t page z 06123/» <br /> 6 'd Z bE9— T 9b 1602 1 umoig a a.a.ae0 ea f, :80 {,p 22 o9a <br />
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