COMPLIANCE INFO_2021 - Laserfiche WebLink

Home Browse Search

U ndergrotin d Storage Tank APPendix XIII Oesignatad U57 Operator Visual inspection Repan Underground Storage TanN Des Ignated UST Operator Visual Inspection Report FAClLfTY INFORMATION — —- 10.TESTING AND MAINTENANCE Ye•s Nu NA cerlarn•ed1g — ---_ _ CLFtS Jr,10B08 Has monitoring syslBm cel[iticahon been CampleEed ininln rhe past [] 8114/2020 Facll fly Name Inspecgan Date io-121202o- 52 months? _ lrtY Mf NI MART 1 rH.sMl container testing been cornplated wdhln the pasl ❑ 611812020 Facllny Address Cii 112 monlha? _ 1756 N. W1LSOfY WAY y 21P Cone _ STOCKTON yDS 11Aas overfill pre anllon equipment inepecdon been completed within ❑ Q 1211112p18 47ESIGNRTED USS OPERATOR 1NFORilrq the past 38 months? Neme IN Desynated 17S-Operator --- Has sawndary comainment testing beencompletee within the pest Q ❑ 21W2018 Pncne 22ne Pimm¢ _ _ 209-7,144112 36 awnths7 ICC Cenihcation Has tame regnlrtess lasflr�been eampfeEad within rBWirad ❑ 86&7us6-VC Cerlificefion Fxpiraiipn Gale limermmes7 LANCE E8. _ v172022 Has line tightness tas4ng been campfeted within the required ❑ ❑ rderrriry df rrumnrr aacnrr�tv�arcn;cn:os ksre7 rimeirames7 _ Other Test I Montememe' D ❑ Other Test I Mantenanea. Q Q Omar Tele I Maintenance: ❑ ❑ 77.FACLITY EMOYEE TRAINING - Yes Hare all.flYltluaia peenm',11Ig li-Iry employes duties received the req uin]d fac lily 1� a�plpyae I'a1n n�wlmin tilt has[12 mcnl}Is? � ❑ 111 COAIYENTE• - T7>,isYecr,'vn Vinay�9 used(p recorC f:prryman(y pr ofxSBrva(,bris rho!ora rrW culieYrl�pmpA'ar♦Lg de!rendes I I I 4.DER(11-1 GAI ION 6Y CESMNAT it U-ST 6PERATOR CONALICTI NG v4sPE"(* hereby cartlly thanis the vual inspncFion was per[armod in compliance wi111 Cali[omia Coda trf Regulations,tide 23,division 3,chaptin 16,VmLi-n 2716 and all information provldad herein is accurate. `iasq+ Ic.-yl�sT gpemtor S�na7ure_ _ 'Cale[ ection R nsp eport Provided to Owner t 9 ; 2020 1Vr anssvars Irulrkwe'N¢'musr be datcybgyby vire GER5 s Calllomie Envirgnmenlal Raponillp System,ICC=Inlemational Cede Council.Id daargnererf = e157 Operator 1n Saclfon S. i8d�e't r$^kNA'Nat Appllcabia,UpC=Urcler-Oispenser Contai nment,UST=Dndergrvund P"84¢14 NO 1 of 4 7 %001 IRWERORpUNO STOgAr,E TANK Underground Storage lank OESlGNATEO UNDERGROUND STORAGE TANK pPERATOR VISUAL INSPECT ON REPORT I 1 a a Designated UST Operator Visual Inspection Report L —FApLITV INFORMATION 81188, —�bAGewvlen usr cycxmn 0819 Br5292D ».ra"' — — Data la- nuWMerrcaro rs.ve+r.�wy rrenpor¢ea�me,,.,eas nm-- 19.TESTING AND MAINTENANGE — Yes I No NA M'r MINI MART - — _.. .Performed -fi�rn+ersreen c �Has mmdarurg system indication been comple[ea wdhln me pall 1756 N.N11LSdN WAY S OCFaON 85205 12 monihs? ❑ 811412020 F, IL OpswAkTEGUNDeRMOUND STORAGE TAMC OPERATOR INF_q_RMATON Hassplll container leskpg Ceen completed wAhintlle pall ^°a�=,v�rdusrre,�,,,.:c1:,;•e.,.,�,,,., 1 12 montM7 ❑ 31781202Q 208 Zane Nimme 7440112 Fcc Icr,ceneae,arF.,pe. Naaarer(P prevention egalpniant inspecrlm been wmple[ed within BB630640C 2+17!2022 the Past 38 months? ❑ ❑ 12111!2018: IIL COe1PLµ110E 9881lES Has secnnderycomralnment testing C-n completed vri[hin the pact rrrr}� ��rr Ae vnaHera eT+r er•en•n,.ern'p,.vu 1�r,�nxl,�,.xe:1,a.;ledm�m..,e-Aa,.,drvei ire rdmmw�+'m 36 meMha7 S4 2/8/2018 1- MONITO1 FRIED,NEyy MOHITpR BEING IN�iALL EU THIS WEGK.PEliFA1 r nPEN Hae-Ktlgmr -—,NLeen avmplMed lughin required �• TESTING AND SENSOR REPORTS AFTER UPGRADE. at Q I 7. ClArC :O ALL 58L+PS SYSTEM DRY tlmrpmes7 J 4 - Has Ilne ngMnexs tasting haen mmpletad vAlhin Rte ra iuired i llmahmnes? Q ❑ - 01hm rest r Maintenance: --- C—* Q 7. CIher Te31 I Mea1[enanpe: g' tawon .-- ❑ ❑ FIE — sl 1 hlainftlnance -- —�❑ 0 15R LfTy EMPL6YEEldiviq�als performingtlte udYag12.[My BLEwnll TANx nNn rNES Nn TESillec,RE7NIRE0 Irainny within the past i2 moMfh? yya•"`—