Laserfiche WebLink
G V E® P.O. Box 4208 <br />Fy{ _ a Sonora CA 95370 <br />Alltec <br />U& <br />�(�Ca: 623541 A-Haz <br />SEP 0 2015 <br />Phone. 209-532-7320 <br />Complionce without Compromise PN, rlR,� NMENTA1 Fax: 209-533-2650 <br />MONITORING SYSTEM CERTIFICATION V�PibV {VyYI 1Y"1 TE.+M ail@ alltechpetro.com <br />ww.alltechpetro.com <br />A. Facility General Information <br />Facility Name: Costco # 1031 Manteca <br />Facility Address: 2440 Daniel St., Manteca CA <br />Facility Contact Person: Dave Zizzo (Ser. Sta. Supervisor); <br />LIA: San Joaquin Health <br />Make/Model of Monitoring System: Veeder-Root TLS -350 <br />B. Inventory of Equipment Tested/Certified: <br />Date of Testing: Tuesday, August 19, 2015 <br />Facility Phone: 209-824-2860 <br />inspector: Jeff Wong. <br />Tank ID: Unleaded 87A Tank 1 <br />Tank ID: Unleaded 878 Tank 2 <br />MIn-Tank Gauging Probe. Model: Mag Plus <br />®In -Tank Gauging Probe. Model: Mag Plus <br />ZTank Annular Space Sensor. Model: 794380-303 <br />ETank Annular Space Sensor. Model: 794380-303 <br />NPiping Sump Sensor(s). Model: 857080-112 <br />®Piping Sump Sensor(s). Model: 857080-112 <br />®Piping Sump Annular: Model: 794380-304 <br />NPiping Sump Annular: Model: 794380-304 <br />®Fill Sump Sensor(s). Model: 794380-323 <br />®Fill Sump Sensor(s). Model: 794380-323 <br />❑Fill Sump annular Model: 794380-304 <br />MFill Sump annular Model: 794380-304 <br />®Secondary Piping monitor Type: Vacuum <br />®Secondary Piping monitor Type: Vacuum <br />® Electronic Line Leak Detector. Model: V -R PLLD <br />® Electronic Line Leak Detector. Model: V -R PLLD <br />❑Tank Overfill / High -Level Sensor. Model- V -R Audible <br />❑Tank Overfill / High -Level Sensor. Model: V -R Audible <br />® Fills ill Bucket Tested: ®Pass ❑Fail <br />❑ Fills ill Bucket Tested: ZPass ❑Fail <br />Tank ID: Unleaded 91 Tank 3 <br />Tank ID: Fuel Additive Tank 4 <br />❑ In -Tank Gauging Probe. Model: Mag Pius <br />® In -Tank Gauging Probe. Model: Mag Plus <br />®Tank Annular Space Sensor. Model: 794380-303 <br />NTank Annular Space Sensor. Model: 794380-303 <br />®Piping Sump Sensor(s). Model: 857080-112 <br />®Piping/Fill Sump Sensor(s). Model: 794380-323 <br />®Piping Sump Annular: Model: 794380-304 <br />❑Piping/Fill Sump Annular: Model: 794380-304 <br />®Fill Sump Sensor(s). Model: 794380-323 <br />❑Secondary Piping monitor Type: Vacuum <br />®Fill Sump annular Model: 794380-304 <br />❑Mechanical Line Leak Detector. Model: FE Petro <br />❑Secondary Piping monitor Type: Vacuum <br />Tank Overfill/ High -Level Sensor. Model: V -R Audible <br />❑Electronic Line Leak Detector. Model: PLLD <br />® Fillspill Bucket Tested: ®Pass ❑Fail <br />❑Tank Overfill / High -Level Sensor. Model: V -R Audible <br />® Fills ill Bucket Tested: 19Pa5s ❑Fail <br />Dispenser ID., 1&2 ® Sump: ®Dry ❑Water ❑Product <br />Dispenser 1D: 3&4 ® Sump: ®Dry ❑Water ❑Product <br />❑Dispenser Containment Sensor(s). Model: 794380-323 <br />®Dispenser Containment Sensor(s). Model: 794380-323 <br />UDC Annular sensor. Model: 794380-304 <br />Z* UDC Annular sensor. Model: 794380-304 <br />❑ Shear Valve(s) (Functional test) <br />Z Shear Valve(s) (Functional test) <br />Dispenser ID: 5&6 0 Sump: ZDry ❑Water ❑Product <br />Dispenser ID: 7&8 Z Sump: ZDry ❑Water ❑Product <br />® Dispenser Containment Sensor(s). Model: 794380-323 <br />® Dispenser Containment Sensor(s). Model: 794380-323 <br />❑ UDC Annular sensor. Model: 794380-304 <br />® UDC Annular sensor. Model: 794380-304 <br />®Shear Valve(s) (Functional test) <br />®Shear Valve(s) (Functional test) <br />Dispenser ID: 9&10 Z Sump: ®Dry ❑Water ❑Product <br />Dispenser ID: 11&12 LA Sump: ®Dry ❑Water ❑Product <br />ER Dispenser Containment Sensor(s). Model: 794380-323 <br />®Dispenser Containment Sensor(s). Model: 794380-323 <br />Z UDC Annular sensor, Model: 794380-304 <br />❑ UDC Annular sensor. Model: 794380-304 <br />❑ Shear Valve(s) (Functional test) <br />❑ Shear Valve(s) (Functional test) <br />Dispenser ID: 13&14 ❑ Sump: ODry ❑Water El Product <br />Dispenser ID: 15&16 0 Sump: ®Dry ❑Water ❑Product <br />Dispenser Containment Sensor(s). Model: 794380-323 <br />❑ Dispenser Containment Sensor(s). Model: 794380-323 <br />® UDC Annular sensor. Model: 794380-304 <br />® UDC Annular sensor. Model: 794380-304 <br />❑Shear Valve(s) (Functional test) <br />®Shear Vafve(s) (Functional test) <br />Dispenser ID: Vent Stack Transition Sump <br />Dispenser ID: Additive Tank Vent Sump <br />® Sump: ®Dry ❑Water ❑Product <br />EE Sump: EDry ❑Water ❑Product <br />Z UDC Sump Containment Sensor(s). Model: 794380-323 <br />® UDC Sump Containment Sensor(s). Model: 794380-323 <br />Z UDC Sump Annular sensor. Model: 794380-304 <br />N UDC Sump Annular sensor. Model: 794380-304 <br />* Sensor installed but not operating properly. <br />Technician: <br />Certification: Veeder-Root B36878, Level 4 <br />ICC UST Service Technician # 8146912 -UT <br />Date: 8/19/15 <br />