COMPLIANCE INFO_2010-2015 - Laserfiche WebLink

Home Browse Search

MONITQSING SYSTEM CERTHWATION MAKE / MODEL OF MONITORING SYSTEM: Veeder-Root TLS -350 CERTIFICATION /TEST DATE: July 12, 2012 A1. FACILITY Name Olympian # 487 Address 983 Moffat Blvd., Manteca, CA 95336 Phone # 530-885-0401 Contact Amanda Appelt A3. CUPA Name San Joaquin County Environmental Health Address 1868 E. Hazelton Avenue, Stockton, CA 95202 Notified July 2, 2012 Inspector Thuy Tran Phone # 209-468-8257 B. Tank #1 (Product): Gasoline - 87 ❑ In -Tank Gauging Probe ■ Annular Space or Vault Sensor ■ Piping Sump / Trench Sensor(s) ❑ Fill Sump Sensor(s) ■ Mechanical Line Leak Detector ❑ Electronic Line Leak Detector ❑ Tank Overfill / High -Level Sensor ❑ Other (specify equipment in Section E) A2. OWNER Name Flyers Energy LLC. Address 2360 Lindbergh Street, Auburn, CA 95602 Phone # 530-885-0401 Contact Amanda Await A4. TESTING CONTRACTOR Name Walton Engineering, Inc. Address P.O. Box 1025, W. Sacramento, CA 95691 Lic # 617238 A, B, Haz Contact Dulcinea Covan Phone # 916-373-1166 TESTED/CERTIFIED (Check the appropriate boxes to indicate equipment inspectedlserviced) B1: TANKS ❑ In -Tank Gauging Probe Tank #2 (Product): Gasoline -91 ❑ Model: ❑ In -Tank Gauging Probe Model: Model: 0794390-420 ❑ Annular Space or Vault Sensor Model: Model: 0794380-208 ■ Piping Sump / Trench Sensor(s) Model: 0794380-208 Model: ❑ Fill Sump Sensor(s) Model: Model: VMI 99LD-2000 _ ■ Mechanical Line Leak Detector Model: VMI. 99LD-2000 Model: ❑ Electronic Line Leak Detector Model: Model: ❑ Tank Overfill / High -Level Sensor Model: 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: 0794390-420 ❑ Annular Space or Vault Sensor Model: ■ Piping Sump / Trench Sensor(s) Model: 0794380-208 ❑ Piping Sump / Trench Sensor(s) Model: ❑ Fill Sump Sensor(s) Model: ❑ Fill Sump Sensor(s) Model: ■ 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: 62: DISPENSERS/UDC's Dispenser # : 1-2 ■ Dispenser Containment Sensor(s) Model: 0794380-208 ■ Shear Valves ❑ Dispenser Containment Float(s) and Chain(s) Dispenser # : 5-6 ■ Dispenser Containment Sensor(s) ■ Shear Valves ❑ Dispenser Containment Float(s) and Dispenser # : 8 Sat ■ Dispenser Containment Sensor(s) ■ Shear Valves ❑ Dispenser Containment Float(s) and Dispenser # : 3-4 ■ Dispenser Containment Sensor(s) ■ Shear Valves ❑ Dispenser Containment Float(s) and Dispenser # : 7-8 Model: 0794380-208 ■ Dispenser Containment Sensor(s) ■ Shear Valves s) ❑ Dispenser Containment Float(s) and Model: 0794380-208 Model: 0794380-208 Dispenser # Model: 0794380-208 ❑ Dispenser Containment Sensor(s) Model: ❑ Shear Valves s) ❑ Dispenser Containment Float(s) and Chain(s) C. CERTIFICATION I certify 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 the 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): ■ System set -ug) ■ Alarm History Rer ort WALTON Signature: ENGINEERING, INC. Technician / Cert M Curtis Carpenter/ B37258 8020679 Date: July 12, 2012