COMPLIANCE INFO_1995-2006 - Laserfiche WebLink

Home Browse Search

MONITQ#ING SYSTEM CERTIFWATION MAKE / MODEL OF MONITORING SYSTEM: Gilbarco EMC CERTIFICATION /TEST DATE: November 30, 2006 Al. FACILITY A2. OWNER Name Nella Oil#427 Name Nella Oil Company, LLC Address 3300 Waterloo Road,Stockton,CA 95205 Address 2360 Lindbergh Street,Auburn,CA 95602 Phone# 530-885-0401 Phone# 530-885-0401 Contact Amanda Massey Contact Amanda Massey A3. C U P A A4. TESTING CONTRACTOR Name San Joaquin County Environmental Health Name Walton Engineering, Inc. Address 304 E Weber Avenue,3rd Floor,Stockton,CA 95202 Address P.O. Box 1025,W.Sacramento,CA 95691 Notified November 15,2006 Lic# 617238 A,B,Haz Inspector Toua Yang Contact Richard Walton Phone# 209-468-9847 Phone# 916-825-3203 B. INVENTORY OF EQUIPMENT TESTED/CERTIFIED (Check the appropriate boxes to indicate equipment inspected/serviced) B1: TANKS Tank#1 (Product): Gasoline-87 1 Tank#2 (Product): Gasoline-89 ■ In-Tank Gauging Probe Model: 0847390-109 ■ In-Tank Gauging Probe Model: 0847390-109 ■ Annular Space or Vault Sensor Model: 0794390-420 ■ Annular Space or Vault Sensor Model: 0794390-420 ■ Piping Sump/Trench Sensor(s) Model: 0794380-208 ■ Piping Sump/Trench Sensor(s) Model: 0794380-208 ❑ Fill Sump Sensor(s) Model: ❑ Fill Sump Sensor(s) Model: ■ Mechanical Line Leak Detector Model: FE Petro STP-MLD ■ Mechanical Line Leak Detector Model: Vaporless 99LD-2000 ❑ 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: Ta ■n In-Tank ngProbe ElIn-Tank#Tank Ga ) Diesel Model: 0847390-109 �' n -Tank Gr ug ng)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: Vaporless 991-6-2000 ❑ 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: — ----------------- 132: DISPENSERS/UDC's Dispenser#: 1 Dispenser#: 2 ❑ Dispenser Containment Sensor(s) Model: ❑ Dispenser Containment Sensor(s) Model: ■ Shear Valves ■ Shear Valves ■ Dispenser Containment Float(s)and Chain(s) ■ Dispenser Containment Float(s)and Chain(s) Dispenser#: 3-4 Dispenser#: 5-6 ❑ Dispenser Containment Sensor(s) Model: ❑ Dispenser Containment Sensor(s) Model: ■ Shear Valves ■ Shear Valves ■ Dispenser Containment Float(s)and Chain(s) ■ Dispenser Containment Float(s)and Chain(s) Dispenser#: 7 Dispenser#: 8 Dispenser Containment Sensor(s) Model: ❑ Dispenser Containment Sensor(s) Model: Shear Valves Shear■ Valves Dispenser Containment Float(s)and Chain(s) ■ Dispenser Containment Float(s)and Chain(s) C. CERTIFICATION 1 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-up ■ Alarm History Report �� y�y� WALTON Signature: '�+i`�X ENGINEERING,INC. Technician/Cert#: Bruce N.Stewart / A31131 5249892-UT Date: November 30, 2006 ©2006 Walton Engineering,Inc.