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COMPLIANCE INFO_2021
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231070
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
12/22/2021 11:10:28 AM
Creation date
1/8/2021 2:24:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231070
PE
2351
FACILITY_ID
FA0006439
FACILITY_NAME
COUNTRY CLUB MOBIL CIRCLE K
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
CURRENT_STATUS
01
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 10. MONITORING SITE PLAN <br /> Date site plan was prepared: <br /> If a site plan has been prepared that shows all required information, you may include it, rather than this page, <br /> with your Monitoring System Certification Form. The site plan must show the general layout of tanks and <br /> identify locations of the monitoring panel, and all leak detection equipment and monitoring locations. Include <br /> a legend for all symbols depicted. <br /> Sits Address. COUNTRY CLUB CIRCLE N—7575 COUNTRY CLUB BLVD STOCKTON,C 4 <br /> - ATG <br /> H STORE. <br /> P <br /> Y _ . . _ . . . . _ . . _ . o !s - . _ . . . <br /> i .. - . . . . . - . . - . . . . <br /> . . . . . . . . . . . . . <br /> . . -137= <br /> T y <br /> H . . . . . . .. . . . . . . .. . . <br /> R _ . . <br /> . . . . . . . . . . <br /> ��-yy I P <br /> 0. .. - . . . . - . . - . . - . - - - - - . <br /> A - . . . . . . . . . . . . . . . <br /> T <br /> 5 <br /> . - - - - - - - - - - - - - - - - - - - - <br /> TOP P - - - - - - - - - - F=FILLS <br /> x Toa T=ILRBr%f <br /> F P=PRl7BE <br /> IrPIPItiGF 9f.= ..- - - V=VAPOR <br /> (-iRRMTS) X=SUMP SENSOR <br /> Ihan-ine of piping - . . - . . . . . . . - . - . . - . - . . - . - - . - . . . . - . . - . . - . L=LeakDetectar <br /> zmt of sump and . . . . - . . . . - - .. - . . ... . . . - . - - - - - . - . . - . . - - . - . M=ilisa%-c <br /> LMC's.No . . . . - . . . . - - .. - . . ... . . . . . . . . . - . . - . . - - . - . S=Brine 5eusdr <br /> . . . . - . . . . <br /> . - . . . . . . . . . . . . . . I=Smart sensor <br /> dratV�g is . . . . - . - .. . - - - - - . . - . . - - . - . S=STP <br /> accurate'Ive ' . . . . . . ... . . . . . . - . . . . . . . - - - . . i=I'Ioals&ClLains <br /> cannot specttfatt E=E 5WP <br /> b_ue prints. COUNTRY CLL-S BLVD- <br /> '!- r <br /> -3ail rlera�rrraiargmarifiammoanalvsrblolaiJracv7{�rr"ghvh"rcranare a <br /> prq(essrurnlOPMWrrork mxfua-de.far E r-mlIrg <br /> aryl is scda <br /> Date znap was drawn: 14M21 <br /> Inshvcfians <br /> IF you already have a diagram that shows al required infomtiation_you reay include it rather than this page,wrth your M nnitoring System C=_rtiiration. On your sib plan, <br /> show the g=_nera'layaui of tanks and piping. Clearly identity locationsnf the fallowing equg)ment,if installed:monitoring system o trol parcels;sensors monhwbg tank <br /> annular spaces,sumps,dispenser pans,spill Dxaainers,or othersecandary cunlaimmew areas;mechanical or ek-0roni!c line leak detsomrs;and rn-tank liquid revel <br /> probes{ff used tot teak deledtjtn). In the space provided,notethe date this Sia Plan was prepazed. <br /> Page 6 of 6 <br />
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