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COMPLIANCE INFO_2007-2008
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231331
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COMPLIANCE INFO_2007-2008
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Last modified
6/20/2023 10:36:46 AM
Creation date
6/3/2020 9:43:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2007-2008
RECORD_ID
PR0231331
PE
2351
FACILITY_ID
FA0000513
FACILITY_NAME
LODI MEMORIAL HOSPITAL
STREET_NUMBER
975
Direction
S
STREET_NAME
FAIRMONT
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
03107039
CURRENT_STATUS
01
SITE_LOCATION
975 S FAIRMONT AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2351_PR0231331_975 S FAIRMONT_2007-2008.tif
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EHD - Public
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� S <br /> F. In-'hank Gauging/SIR Equiprnent: ❑ Check this box if tank gauging is used only for inventory control. <br /> ging or SIR equipment is installed. <br /> 11 Check this box if no tank gau <br /> This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. <br /> Com Mete the following checklist: <br /> [I❑ Yes ❑ No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? <br /> ❑ Yes ❑ No* Were all tank gauging probes visually inspected for damage and residue buildup? <br /> ❑ Yes L3 No* Was accuracy of system product level readings tested? <br /> ❑ Yes ❑ No* Was accuracy of system water level readings tested? <br /> LI Yes I ❑ No* Were all probes reinstalled properly? <br /> ❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> *In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> G. Line Leak Detectors(LLD): /0 Check this box if LLDs are not installed. <br /> Com tete the follo ing checklist: <br /> ® Yes ❑ No* For equipment start-up or annual equipment c ification, was a leak simulated to verify LLD performance? <br /> ❑ N/A (Check all that apply) Simulated leak rate: ❑3 g.p.h.; ❑0.1 g.p.h ; ❑0.2 g.p.h. <br /> ❑ Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? <br /> ❑ Yes ❑ No* Was the testing apparatus properly calibrated? <br /> ❑ Yes ❑ No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? <br /> ❑ N/A <br /> ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? <br /> ❑ N/A <br /> ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled <br /> ❑ N/A or disconnected? <br /> IL3Yes L3 No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system <br /> ❑ N/A malfunctions or fails a test? <br /> Yes ❑ No* For electronic LLDs,have all accessible wiring connections been visually inspected? <br /> ❑ N/A <br /> Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? <br /> *In the Section H,below,describe how and when these deficiencies were or will be corrected. <br /> H. Comments: <br /> Page 3 of 3 03/01 <br />
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