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COMPLIANCE INFO_2024
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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19533
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2300 - Underground Storage Tank Program
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PR0547762
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COMPLIANCE INFO_2024
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Entry Properties
Last modified
10/24/2024 8:45:42 AM
Creation date
2/12/2024 11:45:05 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2024
RECORD_ID
PR0547762
PE
2351 - UST FACILITY - 2481 COMPLIANT
FACILITY_ID
FA0027204
FACILITY_NAME
SAFEWAY FUEL CENTER #0055
STREET_NUMBER
19533
Direction
S
STREET_NAME
MOUNTAIN HOUSE
STREET_TYPE
PKWY
City
MOUNTAIN HOUSE
Zip
95391
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\lsauers1
Supplemental fields
Site Address
19533 S MOUNTAIN HOUSE PKWY MOUNTAIN HOUSE 95391
Tags
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 TLS-350 336.02 <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) ❑ Sump ❑ 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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