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COMPLIANCE INFO_2016 - 2018
Environmental Health - Public
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EHD Program Facility Records by Street Name
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HARNEY
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2300 - Underground Storage Tank Program
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PR0537549
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COMPLIANCE INFO_2016 - 2018
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Last modified
5/3/2021 2:29:35 PM
Creation date
11/8/2018 10:22:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2016 - 2018
RECORD_ID
PR0537549
PE
2351
FACILITY_ID
FA0021617
FACILITY_NAME
HARNEY LANE AMPM
STREET_NUMBER
255
Direction
E
STREET_NAME
HARNEY
STREET_TYPE
Ln
City
Lodi
Zip
95240
APN
062-580-40
CURRENT_STATUS
01
SITE_LOCATION
255 E Harney Ln
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Supplemental fields
FilePath
\MIGRATIONS3\H\HARNEY\255\PR0537549\COMPLIANCE INFO 2016 - PRESENT.PDF
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EHD - Public
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I. Results of Vacuum/Pressure Monitoring Equipment Testing <br /> This page should be used to document testing and servicing of vacuum and pressure interstitial sensors. <br /> Manufacturer:Veeder Root Model:TLS 350 System Type: ❑ Pressure®Vacuum <br /> Sensor ID <br /> S1 <br /> Component(s)Monitored b this Sensor: Re Prod Line <br /> Sensor Functionality Test Result: EPass Fail Interstitial Communication Test Result:M Pass Ej Fail <br /> S2 Com onent s Monitored by this Sensor:Prem Prod Line <br /> Sensor FunctionalityTest Result: ®Pass Fail Interstitial Communication Test Result: Pass Fail <br /> S3 Component(s)Monitored by this Sensor: Vent Line Gas <br /> Sensor FunctionalityTest Result: Pass Fail Interstitial Communication Test Result: ® Pass❑ Fail <br /> S4 Component(s)Monitored by this Sensor:Prem Va or Line <br /> Sensor FunctionalityTest Result: Pass Fail Interstitial Communication Test Result: Pass❑Fail <br /> S5 Com onent(s)Monitored by this Sensor: DSL Prod Line <br /> Sensor Functionali Test Result: Pass Fail Interstitial Communication Test Result: Pass Fail <br /> S6 Component(s)Monitored by this Sensor: DSL Vent Line <br /> _ Sensor FunctionalityTest Result: Pass Fail Interstitial Communication Test Result: ® Pass❑Fail <br /> Component(s)Monitored by this Sensor: <br /> Sensor Functionality Test Result: Pass El Fail Interstitial Communication Test Result: ❑ Pass Fail <br /> Component(s)Monitored by this Sensor: <br /> Sensor Functionali Test Result: LIPass M Fail Interstitial Communication Test lRelt: Pass Fail <br /> Component(s)Monitored b this Sensor: <br /> Sensor Functionality Test Result: Pass Fail Interstitial Communication Test lt. Pass❑ Fail <br /> Com onent(s)Monitored b this Sensor: <br /> Sensor FunctionalityTest Result: ❑Pass Fail Interstitial Communication Testlt: Pass Fail <br /> How was interstitial communication verified? <br /> ❑Leak Introduced at Far End of Interstitial Space' ❑Ga.. e ❑ Visual Inspection ❑ Other DescriSec J,belowVacuumwas restored to operating levels in all interstitials aces: Yes No(If no,describe in Sec J,be <br /> J. Comments <br /> ' If the sensor successfully detects a simulated vacuum/pressure leak introduced to the interstitial space at the furthest point from <br /> the sensor,vacuum/pressure has been demonstrated to be communicating throughout the interstice. <br /> Monitoring Certification Test Report 4 of 5 <br />
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