COMPLIANCE INFO_2016-2018 - Laserfiche WebLink

Home Browse Search

MONITORING SYSTEM CERTIFICATION MAKE / MODEL OF MONITORING SYSTEM: Veeder-Root TLS-350 CERTIFICATION / TEST DATE: April 11, 2018 Al. FACILITY A2. OWNER Name Colonial Energy#40138 Name Colonial Energy, LLC. Address 14000 E.Hwy.88,Lockeford,CA 95237 Address 2860 N.Santiago Blvd.2nd Floor,Orange,CA 92867 Phone# 916-285-7402 Phone# 714-761-5426 Contact Station Manager Contact Victor Hassan A3. C U PA A4. TESTING CONTRACTOR Name San Joaquin County Environmental Health Name Walton Engineering,Inc. Address 1868 E.Hazelton Avenue,Stockton,CA 95202 Address P.O.Box 1025,W.Sacramento,CA 95691 Notified March 27,2018 Lic# 617238 A,B,Haz Inspector Aaron Hang Contact Veronica Freitas Phone# 209-468-3442 Phone# 916-373-1166 B. INVENTORY OF EQUIPMENT TESTED/CERTIFIED (Check the appropriate boxes to indicate equipment inspected/serviced) Bt: TANKS Tank#1 (Product): Gasoline-87 Tank#2 (Product): Gasoline-91 ❑ In-Tank Gauging Probe Model: ❑ In-Tank Gauging Probe Model: ■ Annular Space or Vault Sensor Model: 0794390-420 ■ Annular Space or Vault Sensor Model: 0794390420 Piping Sump/Trench Sensor(s) Model: 0794380-208 0 Piping Sump/Trench Sensoria) Model: 0794380-206 ❑ FIII Sump Sensor(s) Model: ❑ FIII Sump Sensoria) Model: 0 Mechanical Line Leak Detector Model: FE Petro STP-MLD 0 Mechanical Line Leak Detector Model: FE Petro STP-MLD ❑ Electronic Line Leak Detector Model: ❑ Electronic Line Leak Detector Model: ❑ Tank Overfill/High-Level Sensor Model: ❑ Tank Overfill/High-Level Sensor Model: ❑ Other (specify equipment in Section E) Model: ❑ Other (specify equipment in Section E) Model: Tank#3 (Product): Diesel Tank#4 (Product): ❑ In-Tank Gauging Probe Model: ❑ In-Tank Gauging Probe Model: • Annular Space or Vault Sensor Model: 0794390420 ❑ Annular Space or Vault Sensor Model: • Piping Sump/Trench Sensors) Model: 0794380-208 ❑ Piping Sump/Trench Sensors) Model: ❑ Fill Sump Sensors) Model: ❑ Fill Sump Sensor(s) Model: E Mechanical Line Leak Detector Model: VMI 99LD-2000 ❑ Mechanical Line Leak Detector Model: ❑ Electronic Line Leak Detector Model: ❑ Electronic Line Leak Detector Model: ❑ Tank Overfill/High-Level Sensor Model: ❑ Tank Overfill/High-Level Sensor Model: ❑ Other (specify equipment in Section E) Model: ❑ Other (specify equipment in Section E) Model: E12: DISPENSERS/UDC's Dispenser#: 1 .2 Dispenser#: 3-4 ■ Dispenser Containment Sensoria) Model: 0794380-208 ■ Dispenser Containment Sensors) Model: 0794380-208 ❑ Shear Valves ❑ Shear Valves ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser Containment Float(s)and Chain(s) Dispenser#: 5-6 Dispenser#: 7-8 0 Dispenser Containment Sensors) Madel: 0794380-208 N Dispenser Containment Sensors) Model: 0794380-208 ❑ Shear Valves ❑ Shear Valves ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser Containment Float(s)and Chains) Dispenser#: Dispenser#: ❑ Dispenser Containment Sensor(s) Model: ❑ Dispenser Containment Sensor(s) Model: ❑ Shear Valves ❑ Shear Valves ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser Containment Floats)and Chain(s) C. CERTIFICATION Icertify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers'guidelines. Attached to this Certification is information(e.g.manufacturers'checklists)necessary to verify that this information is correct and a Plot Plan showing th layout of monitoring equipment. For any equipment capable of generating such reports,I have also attached a copy of the report; (check all that apply /_� ././��.,. �//�/J ■ System set-up ■ Alarm History Report LTON_- Signature: / IRY- /✓"'— ---�_ �AENGINEERING,INC. Technician I Cert#: Anthony Reyes 846116 8293772 Date: April 11, 2018 ©2018 Walton Engineering,Inc.