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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231760
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COMPLIANCE INFO_2021
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Last modified
8/4/2021 2:07:15 PM
Creation date
3/3/2021 8:18:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231760
PE
2351
FACILITY_ID
FA0003831
FACILITY_NAME
WATERLOO FOODMART
STREET_NUMBER
4315
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
08710034
CURRENT_STATUS
01
SITE_LOCATION
4315 E WATERLOO RD
P_LOCATION
99
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 /> Monitoring System Certification Form <br /> 6. SENSOR TESTING RESULTS <br /> List only sensors tested on date of this certification. List "Sensor ID"as labeled in system <br /> programming. Additional copies of this page may be attached to accommodate all sensors tested. <br /> Sensor lD Sensor Model Component(s) Monitored Pass Fail <br /> L1 208 87 FILL 0 ❑ <br /> L2 208 91 FILL 0 ❑ <br /> L3 208 87 STP 0 ❑ <br /> L4 208 91 STP 0 ❑ <br /> L5 302 87 ANNULAR 0 ❑ <br /> L6 302 91 ANNULAR 0 ❑ <br /> L7 208 DISP 1-2 0 ❑ <br /> L8 208 DISP 3-4 0 ❑ <br /> L9 208 DISP 5-6 0 ❑ <br /> L10 208 DISP 7-8 0 ❑ <br /> L11 304 DISP 1-2 BRINE 0 0 <br /> L12 304 DISP 3-4 BRINE 0 ❑ <br /> L13 304 DISP 5-6 BRINE 0 ❑ <br /> L14 304 DISP7-8 BRINE 0 ❑ <br /> L15 304 87 STP ANN 0 ❑ <br /> L16 304 91 STP ANN 0 ❑ <br /> L17 208 VENT BOX 0 ❑ <br /> L18 304 VENT ANN 0 ❑ <br /> L19 304 87 FILL ANN 0 ❑ <br /> L20 304 91 FILL ANN Z. ❑ <br /> S1 SMART 87 LINE 0 ❑ <br /> S3 SMART 91 LINE 0 ❑ <br /> S4 SMART VENT 0 ❑ <br /> S5 SMART VAPOR 0 ❑ <br /> Describe all answers marked "No"or "Fail'and proposed remedy in Section 9. <br /> List all monitoring equipment either replaced or repaired in Section 9 <br /> Page 3 of 6 <br />
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