Laserfiche WebLink
RECEIVED <br /> AUG 3 0 2018 P.O.Box 4208 <br /> Sonora CA 95370 <br /> Ca:623541 A Haz <br /> ENVIROJMENiA_AlltechPetr - HEALTHUFP/RTMFNi Phone:209-532-7320 <br /> Compliance without Compromise <br /> Fax:209-533-2650 <br /> MONITORING SYSTEM CERTIFICATION for VPH SYSTEMZail@alltechpetro.com <br /> alltechpetro.com <br /> A. Facility General Information <br /> Facility Name: Costco# 1031 Manteca Date of Testing: Tuesday,August 14, 2018 <br /> Facility Address: 2440 Daniel St., Manteca CA <br /> Facility Contact Person: Dave Zizzo (Ser. Sta. Supervisor); Facility Phone: 209-824-2860 <br /> LIA: San Joaquin Health Deparment Inspector: Aaron Hang email:ahang@sjcehd.com <br /> Make/Model of Monitoring System: Veeder-Root TLS-350 <br /> B. Anventory of Equipment Tested/Certified: <br /> Tank ID: Unleaded 87A Tank 1 Tank ID: Unleaded 87B Tank 2 <br /> Nln-Tank Gauging Probe. Model: Mag Plus ®In-Tank Gauging Probe. Model: Mag Plus <br /> ®Tank Annular Space Sensor. Model: 794380-303 NTank Annular Space Sensor. Model:794380-303 <br /> NPiping Sump Sensor(s). Model: 857080-112 NPiping Sump Sensor(s). Model:857080-112 <br /> ®Piping Sump Annular: Model: 794380-304 ®Piping Sump Annular: Model: 794380-304 <br /> N Fill Sump Sensor(s). Model: 794380-323 N Fill Sump Sensor(s). Model:794380-323 <br /> ®Fill Sump annular Model: 794380-304 NFill Sump annular Model:794380-304 <br /> ®Secondary Piping monitor Type:Vacuum NSecondary Piping monitor Type:Vacuum <br /> ®Electronic Line Leak Detector. Model: V-R PLLD NElectronic Line Leak Detector. Model:V-R PLLD <br /> ®Tank Overfill/High-Level Sensor. Model:V-R Audible NTank Overfill/High-Level Sensor. Model:V-R Audible <br /> N Fillspill Bucket Tested: NPass ❑Fail N Fillspill Bucket Tested: ®Pass ❑Fail <br /> Tank ID: Unleaded 91 Tank 3 Tank ID: Fuel Additive Tank 4 <br /> ®In-Tank Gauging Probe. Model: Mag Plus ®In-Tank Gauging Probe. Model: Mag Plus <br /> NTank Annular Space Sensor. Model: 794380-303 NTank Annular Space Sensor. Model: 794380-303 <br /> NPiping Sump Sensor(s). Model: 857080-112 NPiping/Fill Sump Sensor(s). Model: 794380-323 <br /> ®Piping Sump Annular: Model: 794380-304 ®Piping/Fill Sump Annular: Model:794380-304 <br /> ®Fill Sump Sensor(s). Model: 794380-323 NSecondary Piping monitor Type:Vacuum <br /> NFill Sump annular Model:794380-304 NMechanical Line Leak Detector. Model: FE Petro <br /> NSecondary Piping monitor Type:Vacuum NTank Overfill/High-Level Sensor. Model:V-R Audible <br /> N Electronic Line Leak Detector. Model: PLLD N Fillspill Bucket Tested: ®Pass ❑Fail <br /> NTank Overfill/High-Level Sensor. Model:V-R Audible <br /> N Fillspill Bucket Tested: ®Pass ❑Fail <br /> Dispenser ID: 1&2 N Sump: NDry❑Water❑Product Dispenser ID: 3&4 N Sump: NDry❑Water❑Product <br /> N Dispenser Containment Sensor(s). Model: 794380-323 N Dispenser Containment Sensor(s). Model:794380-323 <br /> N UDC Annular sensor. Model: 794380-304 N* UDC Annular sensor. Model: 794380-304 <br /> NShear Valve(s) (Functional test) NShear Valve(s) (Functional test) <br /> Dispenser ID: 5&6 N Sump: NDry❑Water❑Product Dispenser ID: 7&8 N Sump: NDry❑Water❑Product <br /> N Dispenser Containment Sensor(s). Model: 794380-323 N Dispenser Containment Sensor(s). Model:794380-323 <br /> N UDC Annular sensor. Model: 794380-304 N UDC Annular sensor. Model: 794380-304 <br /> NShear Valve(s) (Functional test) NShear Valve(s) (Functional test) <br /> Dispenser ID: 9&10 N Sump: NDry❑Water❑Product Dispenser ID: 11&12 N Sump: NDry❑Water❑Product <br /> NDispenser Containment Sensor(s). Model: 794380-323 NDispenser Containment Sensor(s). Model:794380-323 <br /> N UDC Annular sensor. Model: 794380-304 N UDC Annular sensor. Model: 794380-304 <br /> NShear Valve(s) (Functional test) NShear Valve(s) (Functional test) <br /> Dispenser ID: 13&14 N Sump: NDry❑Water❑Product Dispenser ID: 15&16 N Sump: NDry❑Water❑Product <br /> NDispenser Containment Sensor(s). Model: 794380-323 NDispenser Containment Sensor(s). Model: 794380-323 <br /> N UDC Annular sensor. Model:794380-304 N UDC Annular sensor. Model: 794380-304 <br /> NShear Valve(s) (Functional test) NShear Valve(s) (Functional test) <br /> Dispenser ID:Vent Stack Transition Sump Dispenser ID:Additive Tank Vent Sump <br /> N Sump: NDry❑Water❑Product N Sump: NDry❑Water❑Product <br /> N UDC Sump Containment Sensor(s). Model: 794380-323 N UDC Sump Containment Sensor(s). Model:794380-323 <br /> N UDC Sump Annular sensor. Model: 794380-304 N UDC Sump Annular sensor. Model: 794380-304 <br /> *Sensor installed but not operating properly. <br /> Technician: _ Date: 08/14/18 <br /> Certification: Veeder-Root B36878, Level 4 <br /> ICC UST Service Technician # 8146912-UT <br />