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COMPLIANCE INFO_2020
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231211
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COMPLIANCE INFO_2020
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Last modified
10/5/2021 1:26:49 PM
Creation date
5/21/2020 12:39:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0231211
PE
2371
FACILITY_ID
FA0002409
FACILITY_NAME
SAFEWAY FUEL CENTER #2707
STREET_NUMBER
6425
Direction
N
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
CURRENT_STATUS
01
SITE_LOCATION
6425 N PACIFIC AVE
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM (Page 5 of 6) <br /> XII. LINE LEAK DETECTOR TESTING <br /> ❑Check this box if line leak detectors(LLD)are NOT installed.(Do not complete this section.) Y N NA <br /> This section must be completed if LLDs are installed. <br /> Was a leak simulated to verify LLD performance? <br /> © 1:1 El(Check all that apply.) Simulated leak rate verified: 3 GPH ❑ 0.1 GPH ❑ 0.2 GPH <br /> Was the testing apparatus properly calibrated? Q ❑ ❑ <br /> For emergency generator tank systems,does the LLD create an audible and visual alarm when a leak is detected? ❑ ❑ <br /> For mechanical LLDs,does the LLD restrict the flow through the pipe when a leak is detected? ❑ ❑ <br /> For electronic LLDs,does the turbine automatically shut off when a leak is detected? ❑ ❑ <br /> For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? © ❑ ❑ <br /> For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? ❑ ❑ <br /> For electronic LLDs,have all accessible wiring connections been visually inspected for kinks and breaks? Q ❑ ❑ <br /> Were all items on the equipment manufacturer's maintenance checklist completed? ❑ ❑ <br /> Were all LLDs confirmed operational within regulatory requirements? W/❑ 1 ❑ 1 ❑ <br /> For any answer of"N"above, describe in Section Xlll how and when these issues were or will be corrected. <br /> XIII. COMMENTS <br /> 87 has 2 Turbines with PLLD's. <br /> XIV. VACUUM/PRESSURE/HYDROSTATIC MONITORING EQUIPMENT TESTING <br /> Check this box if VPH monitoring is NOT used. (Do not complete this section.) <br /> This section must be completed if VPH monitoring is used to perform leak detection monitoring. <br /> System Type(Mark all that apply.) ❑Vacuum ❑Pressure ❑Hydrostatic <br /> Sensor ID Component(S)Monitored By This Sensor Sensor Functionality Interstitial Communication <br /> Test Test <br /> ❑ Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> ❑Pass ❑Fail ❑Pass ❑Fail <br /> How was interstitial communication verified? ❑Simulated Leak at Far Ends of the Interstitial Space ❑Visual Inspection <br /> ❑Other Describe the method in section XV below. ❑Gauge <br /> Was the vacuum or pressure restored to operating levels in all interstitial spaces? ❑Yes ❑No(Describe the reason in section XV below.) <br /> For any answer of"Fail'above, describe in Section XV how and when these issues were or will be corrected. <br /> XV. COMMENTS <br /> RE- <br /> JUN <br /> 1 0 2020 <br /> ENVIRONMENTAL HEALTH <br /> GPH=Galas Per Hour,Y=Yes,N=No,NA=Not Applicable,VPH=VacuumlPressure/Hydrostafic,ID=Identification <br />
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