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BILLING
Environmental Health - Public
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EHD Program Facility Records by Street Name
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WATERLOO
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6732
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2300 - Underground Storage Tank Program
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PR0231830
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BILLING
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Entry Properties
Last modified
7/6/2020 4:37:43 PM
Creation date
11/7/2018 12:45:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
RECORD_ID
PR0231830
PE
2361
FACILITY_ID
FA0004030
FACILITY_NAME
THREE PALMS GROCERY
STREET_NUMBER
6732
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
10110001
CURRENT_STATUS
02
SITE_LOCATION
6732 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\IAError\W\WATERLOO\6732\PR0231830\BILLING.PDF
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EHD - Public
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NIFIED PROGRAM CONSOLIDATED FOR <br />TANKS <br />w <br />UNDERGROUND STORAGE TANKS - TANK PAGE 2 <br />VL PIPING,CONSTRUCTNON (CMckKMafappy) <br />❑ 3. GRAVITY ❑ 1, PRESSURE <br />UU 1 SINGLE WALL ❑ 3. UNEDTRENCH ❑ 99. OTHER ❑ i. SINGLE WALLy <br />11(2. DOUBLE WALL ❑ 95, UNKNOWN ❑ _�,.❑ 95. UNKNONN <br />MANUFACTURER 2. DOUBLE WALL ❑ BSI. OTHER <br />MANUFACTURER <br />❑ 1. BARE STEEL <br />13Z STAINLESS STEEL <br />❑ B. FRP COMPATIBLE WI IDB% METHANOL <br />11T, GALVANIZED <br />❑ 1. BARESTEEL <br />11 e. FRP EW/100%METHANOL <br />STEEL <br />❑ 3. PLASTICCOMPATIBLE`MTHCONTENTS ❑B5. UNKNOWN <br />❑ Z. STAINLESS STEEL <br />❑ 3. PLASTIC COMPATIBLE <br />❑ T. GALVANIZEDSTEEL STEEL <br />�GK4 FIBERGLASS <br />DIS. <br />❑ S. FLEXIBLE(HOPE) 1188 OTHER <br />WITH CONTENTS <br />114, FIBERGLASS <br />❑ e. FLEXIBLE(MOPE) N. OTHER <br />❑ P. CATHODIC PROTECTION <br />STEEL WI COATING <br />❑ 9, CATHODIC PROTECTION <br />❑ 5. STEEL WICOATNG ❑ 95. UNKNOWN <br />0 <br />PIPING <br />SINGLE WALL PIPING ABUVEGROUND PIPING <br />PRESSURIZED PIPING (Deck ak Ila,.. PRESSURIZED PIPING (CMck aN fMl apply): SINGLE WgLL PIPING <br />❑ 1. LEAK.ELECSYSTEM <br />UNE LEAK DETECTOR 3.0 GPM TEST WITH AUTO PUMP SHUT OFF FOR ❑ 1, ELECTRONIC LINE LEAK DETECTOR 3.0 GPM TEST WITH AUTO PUMP SHUT OFF FOR LEAK, <br />LEAK, SYSTEM FAILURE. AND SYSTEM DISCONNECTION AUDIBLE AND VISUAL SYSTEM FAILURE, AND SYSTEM DISCONNECTION F AUDIBLE AND VISUAL ALARMS <br />ALARMS <br />❑ 2. MONTHLY 0ZGPHTEST ❑ 2_ MONTHLY 02 GPM TEST <br />❑ 3. ANNUALINTEGRITY TEST (0 1 GPM) ❑ 3. ANNUAL INTEGRITY TEST (0,1 GPM) <br />❑ a. DAILY VISUAL CHECK <br />CONVENTIONAL SUCTION SYSTEMS. <br />❑ 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM+ TRIENNIAL PIPING INTEGRITY <br />TEST (01 GPM) <br />SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): <br />❑ T. SELF MONITORING <br />GRAVITY FLOW <br />❑ 9. BIENNIAL INTEGRITY TEST III i GPM) <br />10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND <br />w ana) <br />I�� AUTO PUMP SHUT OFF NMENq LEAK OCCURS <br />5 AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM <br />DISCONNECTION <br />❑ c. NOAUTO PUMP SHUTOFF <br />❑ 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPM TEST) WITH FLOW SHUT OFF OR <br />RESTRICTION <br />❑ 12. ANNUAL INTEGRITY TEST (0 1 GPM) <br />,SUCTIOWGRAVITY SYSTEM <br />Or 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS <br />cn wnAi-y' II UN SYSTEMS(CMpk aIfMlapply): <br />❑ S. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM <br />❑ S TRIENNIAL INTEGRITY TEST (0 1 GPM) <br />SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING). <br />❑ T. SELF MONITORING <br />GRAVITY FLOW (CMekaN Mal appy). <br />❑ e. DAILY VISUAL MONITORING <br />❑ 9. BIENNIAL INTEGRITY TEST (0.1 GPM) <br />SECONDARILY CONTAINED PIPING <br />PRESSURIZED PIPING (Check ab fMl appy): <br />10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (tlierA om) <br />❑ a, AUTO PUMP SHUT OFF WIZEN A LEAK OCCURS <br />❑ 0. AUTO PUMP SMUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION <br />❑ c. NO AUTO PUMP SHUT OFF <br />❑ 11. AUTOMATICLPAKOETECTOR <br />❑ 12. ANNUAL INTEGRITY TEST (0.1 GPM) <br />SUCTIONIGRAVITY SYSTEM: <br />❑ 13. CONTINUOUS SUMP SENSOR AUDIBLE AND VISUAL ALARMS <br />EMERGENCY GENERATORS ONLY (CMck a9 fMf apply) EMERGENCY GENERATORS ONLY (Clxk , Mal, appy» <br />❑ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF . AUDIBLE AND ❑ 1a. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF . AUDIBLE AND VISUAL <br />VISUALALARMS ALARMS <br />❑ 15. AUTOMATIC LINE LEAK DETECTOR (30 GPM TEST) WITHOUT FLOW SHUT OFF OR ❑ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPM TES) <br />RESTRICTION <br />❑ 1e. ANNUAL INTEGRITY TEST (0.1 GPM) ❑ 1E. ANNUAL INTEGRITY TEST 10.1 GPM) <br />❑ 17. DAILYVISUALCHECK ❑ 17. DAILY VISUAL CHECK <br />VUL DISPENSER CONTAINMENT <br />DISPENSER CONTAINMENT ❑ 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ❑ A. DAILYVISUAL CHECK <br />DATE INSTALLED _ ❑ 2. CONTINUOUS DISPENSER PAN SENSOR a AUDIBLE AND VISUAL ALARMS ❑ 5. TRENCHUNER/MONITORING <br />❑ 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER- AUDIBLE AND VISUAL ALARMS ❑ S. NONE <br />b/i3/i0/ <br />t�F�._ ITOR u��WAj7N_ <br />CUPAFORM ! <br />(4/99) J <br />Fonnerly SWRCS Farm 8 <br />
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