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COMPLIANCE INFO_2023
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2300 - Underground Storage Tank Program
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PR0231320
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COMPLIANCE INFO_2023
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Last modified
12/1/2023 9:46:46 AM
Creation date
1/18/2023 8:57:22 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0231320
PE
2361
FACILITY_ID
FA0003602
FACILITY_NAME
TESORO (SPEEDWAY) 68151
STREET_NUMBER
35
Direction
N
STREET_NAME
CHEROKEE
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04318003
CURRENT_STATUS
01
SITE_LOCATION
35 N CHEROKEE LN
P_LOCATION
02
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 /> 5. MONITORING SYSTEM AND PROGRAMMING <br /> A separate Monitoring System Certification Form must be prepared for each control panel. <br /> Make of Monitoring System Model of Monitoring System Software Version Installed <br /> Control Panel Control Panel <br /> Veeder Root/Gilban TLS-350/EMC 122.00 <br /> Attach the post-certification reports if the monitoring system is capable of generating Yes No NA <br /> either; ❑✓ Monitoring System Set-up ❑✓ Alarm History Report <br /> All monitoring equipment is operational per manufacturer's specifications? ✓❑ ❑ <br /> Secondary containment systems are free of damage, debris, or liquid? ❑✓ ❑ <br /> Are the audible and visual alarms operational? ❑✓ ❑ <br /> All sensors have been: 1) visually inspected for wiring kinks, breaks and residual ❑✓ ❑ ❑ <br /> buildup on floats; and 2) tested for functionality and confirmed operational? <br /> Are all sensors installed to detect a release at the earliest opportunity in the ✓❑ ❑ ❑ <br /> secondary containment? <br /> The monitoring system set-up was reviewed, and proper settings confirmed? ✓❑ ❑ ❑ <br /> Was the monitoring control panel's backup battery visually inspected, functionally ✓❑ ❑ ❑ <br /> tested, and confirmed operational? <br /> Does the flow of fuel stop at the dispenser if a release is detected in the under- ❑✓ ❑ ❑ <br /> dispenser containment? <br /> Does the turbine automatically shut down if the piping secondary containment ❑ ❑ ❑ <br /> monitoring system fails to operate or is electrically disconnected? <br /> Does the turbine automatically shut down if the piping secondary containment <br /> monitoring system detects a release? Which sensors initiate positive shut down? ❑✓ ❑ ❑ <br /> Check all that apply) ❑✓ Sum ❑ UDC <br /> If monitoring system alarms are relayed to a remote monitoring center, is all ❑✓ ❑ ❑ <br /> communication equipment operational? <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 2 of 6 <br />
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