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COMPLIANCE INFO_2021
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231706
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COMPLIANCE INFO_2021
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Last modified
10/17/2022 4:20:09 PM
Creation date
3/31/2021 3:22:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231706
PE
2361
FACILITY_ID
FA0000485
FACILITY_NAME
FLAG CITY CHEVRON
STREET_NUMBER
6421
STREET_NAME
CAPITOL
STREET_TYPE
AVE
City
LODI
Zip
95242
APN
05532024
CURRENT_STATUS
01
SITE_LOCATION
6421 CAPITOL AVE
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 ID Sensor Model Component(s) Monitored Pass Fail <br /> L1 409 91 ANNULAR ❑✓ ❑ <br /> L2 409 87 MASTER ANNULAR 0 ❑ <br /> L3 409 87 SLAVE ANNULAR Z ❑ <br /> L4 409 DSL ANNULAR 0 ❑ <br /> L5 208 91 STP ID ❑ <br /> L6 208 87 MASTER STP 0 ❑ <br /> L7 208 87 SLAVE STP 0 ❑ <br /> L8 208 DSL STP 0 ❑ <br /> L9 208 91 FILL 0 ❑ <br /> L10 208 87 MASTER FILL 0 ❑ <br /> L11 208 87 SLAVE FILL 0 ❑ <br /> L12 208 DSLFILL 0 ❑ <br /> L13 208 1 - 2 0 ❑ <br /> L14 208 34 0 ❑ <br /> L15 208 5 - 6 0 ❑ <br /> L16 208 7 - 8 0 ❑ <br /> L17 208 9 - 10 0 ❑ <br /> L18 208 11 - 12 0 ❑ <br /> L19 208 SECONDARY VAPOR 0 ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <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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