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COMPLIANCE INFO_2021
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231331
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
12/8/2021 2:09:51 PM
Creation date
1/5/2021 8:59:33 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231331
PE
2351
FACILITY_ID
FA0000513
FACILITY_NAME
LODI MEMORIAL HOSPITAL
STREET_NUMBER
975
Direction
S
STREET_NAME
FAIRMONT
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
03107039
CURRENT_STATUS
01
SITE_LOCATION
975 S FAIRMONT AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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Underground Storage Tank <br /> Overfill Prevention Equipment Inspection Report <br /> 6. OVERFILL PREVENTION EQUIPMENT DETAILS <br /> Tank ID (one OPE per column) DIESEL 20-K DIESEL 5-K <br /> Are both vent and tank riser piping p Yes ❑ Yes ❑ Yes ❑ Yes <br /> secondarily contained? ❑ No 0 No p No ❑ No <br /> OPE Model MAG 1 Probe OPW 61 SO <br /> What is the OPE response when activated? ❑ Shut off p Shut off 0 Shut off ❑ Shut off <br /> (Check all that apply.) Flow Flow Flow Flow <br /> ❑Restricts ❑Restricts ❑Restricts ❑Restricts <br /> Flow Flow Flow Flow <br /> 0 Audible ❑ Audible ❑ Audible ❑ Audible <br /> Alarm Alarm Alarm Alarm <br /> 0 Visual ❑ Visual ❑ Visual ❑ Visual <br /> Alarm Alarm Alarm Alarm <br /> Are flow restrictors installed on vent piping ❑ Yes* ❑ Yes* ❑ Yes* ❑ Yes* <br /> that may interfere with the OPE operation? p No p No 0 No ❑ No <br /> At what level in the tank is the OPE set to 100 <br /> 68 <br /> activate? Inches from bottom of tank <br /> What is the percent capacity of the tank at 90 75.7 <br /> which the OPE activates? <br /> Is the OPE in proper operating condition to p Yes ❑✓ Yes ❑ Yes ❑ Yes <br /> respond when the stored substance ❑ No ❑ No ❑ No ❑ No <br /> reaches the designated regulatory level? <br /> 7. SUMMARY OF TESTING RESULTS <br /> OPE Inspection Results <br /> p Pass ❑✓ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 8. COMMENTS <br /> Describe all results marked "Fail"and each proposed remedy. <br /> * Mark here if: <br /> ❑ Flow restrictors interfere with overfill prevention and equipment repairs required. <br /> Additional copies of this page may be attached. <br /> Attach tank chart(s), measurements, calculations, and In-Tank Setup report(s) <br /> Page 2 of 2 <br />
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