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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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2300 - Underground Storage Tank Program
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PR0232482
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COMPLIANCE INFO 2016 - 2018
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Last modified
10/9/2019 3:44:53 PM
Creation date
10/9/2019 1:31:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2016 - 2018
RECORD_ID
PR0232482
PE
2361
FACILITY_ID
FA0003719
FACILITY_NAME
WEST LANE CHEVRON
STREET_NUMBER
4747
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95210
APN
10437010
CURRENT_STATUS
01
SITE_LOCATION
4747 WEST LN
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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KBlackwell
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EHD - Public
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F. In -Tank Gauging / SIR Equipment: ® Check this box if tank gauging is used only for inr ICEIVED <br />❑ Check this box if no tank gauging or SIR equipmI � <br />This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. <br />Complete the following checklist: <br />FEB 0 2 2016 <br />® <br />Yes <br />❑ <br />No` <br />Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br />® <br />Yes <br />❑ <br />No` <br />Were all tank gauging probes visually inspected for damage and residue buildup? <br />® <br />Yes <br />❑ <br />No' <br />Was accuracy of system product level readings tested? HFALTNDEMN <br />® <br />Yes <br />❑ <br />No' <br />Was accuracy of system water level readings tested? <br />z <br />Yes <br />El <br />No* <br />Were all probes reinstalled properly? <br />® <br />Yes <br />❑ <br />No* <br />I Were all items on the equipment manufacturer's maintenance checklist completed? <br />In Section H, below, describe how and when these deficiencies were or will be corrected. <br />Line Leak Detectors (LLD): ❑ Check this box if LLDs are not installed. <br />ComDlete the followino checklist: <br />TAL <br />VENT <br />® <br />Yes <br />❑ <br />No' <br />For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) <br />❑ <br />N/A <br />Simulated leak rate: ® 3 g.p.h.; ❑ 0.1 g.p.h ; ❑ 0.2 g.p.h. <br />® <br />Yes <br />❑ <br />No' <br />Were all LLDs confirmed operational and accurate within regulatory requirements? <br />® <br />Yes <br />❑ <br />No` <br />Was the testing apparatus properly calibrated? <br />❑ <br />Yes <br />❑ <br />No` <br />For mechanical LLDs, does the LLD restrict product flow if it detects a leak? <br />® <br />N/A <br />® <br />Yes <br />❑ <br />No' <br />For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? <br />❑ <br />N/A <br />® <br />Yes <br />❑ <br />No' <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br />❑ <br />N/A <br />® <br />Yes <br />❑ <br />No' <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br />❑ <br />N/A <br />® <br />Yes <br />❑ <br />No' <br />For electronic LLDs, have all accessible wiring connections been visually inspected? <br />❑ <br />N/A <br />® <br />Yes <br />❑ <br />No` <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />. In Section H, below, describe how and when these deficiencies were or will be corrected. <br />H. Comments: <br />Monitoring System Certification Page 3 of 2/21/07 <br />
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