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COMPLIANCE INFO_2022
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231669
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COMPLIANCE INFO_2022
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Last modified
11/18/2022 11:21:29 AM
Creation date
3/25/2022 1:54:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0231669
PE
2361
FACILITY_ID
FA0001480
FACILITY_NAME
JACKSONS ENERGY #6822
STREET_NUMBER
2132
STREET_NAME
MARIPOSA
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
17306035
CURRENT_STATUS
01
SITE_LOCATION
2132 MARIPOSA RD
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 /> 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 794380-208 DISPENSER 13 & 14 ✓❑ ❑ <br /> L2 794380-208 DISPENSER 5 & 6 ✓❑ ❑ <br /> L3 794380-208 DISPENSER 7 &8 ❑✓ ❑ <br /> L4 794380-208 DISPENSER 11 & 12 ✓❑ ❑ <br /> L5 794380-208 DISPENSER 3 &4 ✓❑ ❑ <br /> L6 794380-208 DISPENSER 9 & 10 ❑✓ ❑ <br /> L7 794380-208 DISPENSER 1 &2 ✓❑ ❑ <br /> L9 794380-208 UNLEAD STP SUMP ❑✓ ❑ <br /> L10 794380-208 PLUS STP SUMP ❑✓ ❑ <br /> L11 794380-208 PREMIUM STP SUMP ✓❑ ❑ <br /> L12 794380-208 DIESEL STP SUMP ❑✓ ❑ <br /> L13 794380-208 UNLEAD FILL SUMP ❑✓ ❑ <br /> L14 794380-208 PLUS FILL SUMP ✓❑ ❑ <br /> L15 794380-208 PREMIUM FILL SUMP ❑✓ ❑ <br /> L16 794380-208 DIESEL FILL SUMP ❑✓ ❑ <br /> L17 Ronan LS3 UNLEAD ANNULAR ❑✓ ❑ <br /> L18 794390-420 PLUS ANNULAR ❑✓ ❑ <br /> L19 Ronan LS3 PREMIUM ANNULAR ✓❑ ❑ <br /> L20 Ronan LS3 DIESEL ANNULAR ❑✓ ❑ <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 3of6 <br />
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