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INSTALL 1998
Environmental Health - Public
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EHD Program Facility Records by Street Name
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DR MARTIN LUTHER KING JR
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701
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2300 - Underground Storage Tank Program
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PR0231059
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INSTALL 1998
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Last modified
6/11/2019 8:14:42 AM
Creation date
11/14/2018 4:28:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
1998
RECORD_ID
PR0231059
PE
2361
FACILITY_ID
FA0002512
FACILITY_NAME
GSG GAS & MART
STREET_NUMBER
701
Direction
E
STREET_NAME
DR MARTIN LUTHER KING JR
STREET_TYPE
BLVD
City
STOCKTON
Zip
95206
APN
14734311
CURRENT_STATUS
01
SITE_LOCATION
701 E DR MARTIN LUTHER KING JR BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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KBlackwell
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EHD - Public
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i <br /> Modern Welding Company, Inc. <br /> Installation Checklist - GlasteelII Jacketed Steel <br /> OWNER OF TANK: jk'f_S �; S :t ("-�f f� if X U.L. Label No. M 17 7 4 3 4 <br /> 'LOCATION OF TANK �p/ �� Sr�c,��cw K�Ylt1I�'��X?IK�Xl9�3-Z6-98 <br /> c,�.��?C�uf.��' r#����DATE. <br /> 20.000 ? Cfynp. <br /> TANK CAPACITY(GALLONS) ivi & -- <br /> VACUUM RECORD <br /> RECORD VACUUM AT TIME OF DELI"VE"RY orches lig <br /> DELIVERY DRIVER INITIAL ,C-_; C'US-TOMER/INSTALLER INPI'IAL <br /> VACUUM JUST PRIOR TO,INSTALLATION inubes lig <br /> TANK HANDLING <br /> Equipment haA su. ent capacity and sire to lift-and lower the tank without dropping <br /> or dragpog the tank? [,4YES [ ]NO <br /> If the tank is being stored,is the storage wea secure and free of foreign matter that <br /> would damage the tank surface? (�4 YES [ ]NO <br /> The stored tusk hats been cl otAed with tires or other Suitable non-abrasive cuebifonine- YES [ ]NO <br /> NOTE: Proper tire disposal shall be the responsibility of the mstallex_ <br /> INSPECTION <br /> Has the tank exterior been uvapetod and any damage properly repaired? [4'�YFS [ ]NO <br /> Have shipping plugs and thread pmGeoors been removed from all openings (excluding <br /> vactlrum gage bcadon)and pelmianent metal plugs installed in the unused openings? [V(WS [ ]NO <br /> TESTING <br /> T the fact installed vacuum gage indicate at lea4t 45.3 inches:lig vacuum cmc.the <br /> interstice? [YJ YES [ ]NO <br /> Have all local or state requirements been m.et? YES [ ] NO <br /> EXCAVATION AND BEDDING <br /> is the excAvation free of any material or object that may cause damage to the tank <br /> eaterior? NO <br /> Has the bottoms of the excavation been suitably graded and a minimuut of 6 in, clean <br /> sand, pea gavel or crusbed stone io dallied to serve as bedding m Tial? [2..1`YES { ]NO <br /> Is the burial depth of the tank withiio it's lasted burial rating?'t Y8s ( ]NO <br /> Do burial depthq meet the um code requirements? [t YES [ j NO <br /> ANCHORING <br /> (Indicate Choice) ondizimi anchors t ] Pavement and soil overburden is adequate to hold down tank <br /> [ ] Concrete pad [allot applicable at this site <br /> For a concrete pact installation, has the minimum 6 inches of clean sand, pea gravel or <br /> erushed atone been placed'between the tank and pad? [ ] YES [ O <br /> Do the anchor straps have insulating, dielectric material separating them from the tank? [ ] YE+ [ ]NO <br /> Is the tank elei-•tricAly isolated from the anchor straps? [ I YES ,I I NO <br /> BACKFILL <br /> "Has approved backfill material been used? (.Refer to installation instructions) [f`E YES ( ]NQ <br /> Has specialbeen used to ensure backfill compaction along the tank's botttma <br /> quadrant9 [(YES [ )NO <br /> PIPING CONNECTIONS <br /> (Select any that apply) t l Metallic ppuig used 1 ]Non-metallic piping used [. I Dielectric bushings or <br /> flanges us&L <br /> If"No" is indicated on aoy of the above questions,please provide explanation: (Attach additional,sh". t if <br /> required.) <br /> Signature$c Title of Foreman/Project Engineer Test on Contractor <br />
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