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COMPLIANCE INFO_2014-2018
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2300 - Underground Storage Tank Program
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PR0232494
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COMPLIANCE INFO_2014-2018
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Last modified
10/23/2023 1:27:31 PM
Creation date
6/3/2020 9:57:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2014-2018
RECORD_ID
PR0232494
PE
2361
FACILITY_ID
FA0002602
FACILITY_NAME
KAISER PERMANENTE
STREET_NUMBER
7373
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95210
APN
09416023
CURRENT_STATUS
01
SITE_LOCATION
7373 WEST LN
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0232494_7373 WEST_2014-2018.tif
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EHD - Public
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F. In-Tank Gauging/SIR Equipment: ❑ Check this box if tank gauging is used only for inventory control. <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. <br /> Complete the following checklist: <br /> V 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 /> 0 Yes ❑ No* Was accuracy of system water level readings tested? <br /> Yes ❑ No* Ware all probes reinstalled properly? �$ <br /> Yes No* Were all Items on the equipment manufacturers maintenance checklist completed? <br /> •In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors(LLD): © Check this box if LLDs are not installed. - 3 7 0' <br /> Complete the following checkilst: r :. ' +"VH <br /> ❑ Yes No* For equipment start-up or annual-quipmentAertification,W4s a leak simulated toverify"LLd performance F, aH <br /> WA that apply) 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 ow if it detects a leak? <br /> N/A <br /> T77e-s No' For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> NIA <br /> ❑ Yes No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or <br /> NIA disconnected? <br /> Y <br /> es No* For electronic LLDs, does the turbine automatically shut if any portion of the monitoring system malfunctions or <br /> NIA fails a test? <br /> �]No* For electronic LLDs,have all accessible wiring connections been pisuallyinspected? <br /> ❑ NIA <br /> U No* Were all items on the equipment manufacturers maintenance checklist completed? <br /> *In the Section H,below,describe how and when these deficiencies were or.will be corrected. <br /> f <br /> H. Comments: <br /> s <br /> Monitoring System Certification Page 3 of 4 12107 <br />
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