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COMPLIANCE INFO_2022
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231736
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
1/12/2023 11:27:50 AM
Creation date
8/15/2022 8:30:42 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0231736
PE
2361
FACILITY_ID
FA0002562
FACILITY_NAME
Sutter Valley Hospitals dba Sutter Tracy Community Hospital
STREET_NUMBER
1420
Direction
N
STREET_NAME
TRACY
STREET_TYPE
Blvd
City
Tracy
Zip
95376
APN
233-081-01
CURRENT_STATUS
01
SITE_LOCATION
1420 N Tracy Blvd
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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<br />Underground Storage Tank <br />Overfill Prevention Equipment Inspection Report <br />Additional copies of this page may be attached. <br /> <br />Attach tank chart(s), measurements, calculations, and In-Tank Setup report(s) <br />Page 2 of 2 <br /> <br />6. OVERFILL PREVENTION EQUIPMENT DETAILS <br /> <br />Tank ID (one OPE per column) T1 DSL <br />Are both vent and tank riser piping <br />secondarily contained? <br />☐ Yes <br />☒ No <br />☐ Yes <br />☐ No <br />☐ Yes <br />☐ No <br />☐ Yes <br />☐ No <br />OPE Model OPW <br />What is the OPE response when <br />activated? <br />(Check all that apply.) <br />☒ Shut off <br /> Flow <br />☐Restricts <br /> Flow <br />☐ Audible <br /> Alarm <br />☐ Visual <br /> Alarm <br />☐ Shut off <br /> Flow <br />☐Restricts <br /> Flow <br />☐ Audible <br /> Alarm <br />☐ Visual <br /> Alarm <br />☐ Shut off <br /> Flow <br />☐Restricts <br /> Flow <br />☐ Audible <br /> Alarm <br />☐ Visual <br /> Alarm <br />☐ Shut off <br /> Flow <br />☐Restricts <br /> Flow <br />☐ Audible <br /> Alarm <br />☐ Visual <br /> Alarm <br />Are flow restrictors installed on <br />vent piping that may interfere with <br />the OPE operation? <br />☐ Yes* <br />☒ No <br />☐ Yes* <br />☐ No <br />☐ Yes* <br />☐ No <br />☐ Yes* <br />☐ No <br />At what level in the tank is the <br />OPE set to activate? (Inches from <br />102 inches <br />What is the percent capacity of the <br />tank at which the OPE activates? <br />93 % <br />Is the OPE in proper operating <br />condition to respond when the <br />stored substance reaches the <br />designated regulatory level? <br />☒ Yes <br />☐ No <br />☐ Yes <br />☐ No <br />☐ Yes <br />☐ No <br />☐ Yes <br />☐ No <br /> <br />7. SUMMARY OF TESTING RESULTS <br /> <br />OPE Inspection Results ☒ Pass <br />☐ Fail <br />☐ Pass <br />☐ Fail <br />☐ Pass <br />☐ Fail <br />☐ Pass <br />☐ Fail <br />1 <br />8. COMMENTS <br /> <br />Describe all results marked “Fail” and each proposed remedy. <br /> <br /> <br /> <br /> <br />* Mark here if: <br />☐ Flow restrictors interfere with overfill prevention and equipment repairs required. <br /> <br />
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