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COMPLIANCE INFO_2023
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2300 - Underground Storage Tank Program
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PR0231669
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COMPLIANCE INFO_2023
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Last modified
7/5/2023 8:52:32 AM
Creation date
3/31/2023 8:59:21 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
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 VR 794380-208 Dispensers 13& 14 ✓❑ ❑ <br /> L2 VR 794380-208 Dispenser 5 &6 ✓❑ ❑ <br /> L3 VR 794380-208 Dispenser 7&8 ❑✓ ❑ <br /> L4 VR 794380-208 Dispenser 11 & 12 ✓❑ ❑ <br /> L5 VR 794380-208 Dispenser 3 &4 ✓❑ ❑ <br /> L6 VR 794380-208 Dispenser 9 & 10 ❑✓ ❑ <br /> L7 VR 794380-208 Dispenser 1 &2 ✓❑ ❑ <br /> L9 VR 794380-208 Unleaded STP Sump ❑✓ ❑ <br /> L10 VR 794380-208 Plus STP Sump ❑✓ ❑ <br /> L11 VR 794380-208 Premium STP Sump ✓❑ ❑ <br /> L12 VR 794380-208 Diesel STP ❑✓ ❑ <br /> L13 VR 794380-208 Unleaded Fill Sump ❑✓ ❑ <br /> L14 VR 794380-208 Plus Fill Sump ✓❑ ❑ <br /> L-15 VR 794380-208 Premium Fill Sump ❑✓ ❑ <br /> L16 VR 794380-208 Diesel Fill Sump ❑✓ ❑ <br /> L17 Ronan LS 3 Unleaded Annular ❑✓ ❑ <br /> L18 Vr 794390-420 Plus Annular ❑✓ ❑ <br /> L19 Ronan LS 3 Premium Annular ✓❑ ❑ <br /> L20 Ronan LS 3 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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