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COMPLIANCE INFO_1997-2006
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231766
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COMPLIANCE INFO_1997-2006
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Last modified
12/20/2023 3:52:47 PM
Creation date
6/3/2020 9:53:03 AM
Metadata
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Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1997-2006
RECORD_ID
PR0231766
PE
2361
FACILITY_ID
FA0003717
FACILITY_NAME
CHEVRON STATION #99840*
STREET_NUMBER
4344
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
Rd
City
Stockton
Zip
95215
APN
10102156
CURRENT_STATUS
01
SITE_LOCATION
4344 E Waterloo Rd
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
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\MIGRATIONS\UST\UST_2361_PR0231766_4344 E WATERLOO_1997-2006.tif
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EHD - Public
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RXXEE INTL TI T - Single Wall and Double Wall <br />Fiberglass Underground Storage Tanks) <br />CORPORA71710 Yof//L Q'E� Cd 4r �' 7a and Oil/Water Separators <br />The installing contractor must read the installation manual and complete this checklist to validate the Xerxes warranty. The tank owner must retain a <br />copy of this checklist and a copy of all deviation authorization to substantiate any warranty claim. <br />` • Date of Installation Tank Size and Capacity <br />• Tank Type SW DW WET DRY COMP OWS (circle those that apply) UL Number <br />• Site Owner <br />• Site Address <br />sues, Suit Ao <br />• Installing Contractor <br />.. ' • Verified by: <br />A. Visual Inspection. No evidence of damage (holes, cracks, gouges) in tank (document any damage found) ................. <br />B. Brine Tanks: 1. Check and record brine level in reservoir (inches) ....................................... <br />2. Check for brine inside tank............................................................... <br />C. Physical Test. Preinstallation air/'soap test completed in accordance with installation instructions ...................... <br />D. Backfill material (indicate which type) 1. Pea gravel or crushed stone as specified by XERXES ....................... <br />2. Other (requires specific approval by XERXES (describe) .................... <br />E. Excavation. Hole dimensions are correct per installation instructions for appropriate conditions ........................ <br />F. Internal Measurement. The inside diameter of the tank has been measured and documented (Dimension A Below) ......... <br />G. Filter Fabric Utilized. (indicate one) 1. Yes 2. No ....................................................... <br />H. Hole Condition. (indicate one) 1. Dry hole. Water not anticipated to reach tank. Area not subject to flooding ........... <br />2. Wet hole. Excavation may trap water. Area subject to flooding ..................... <br />I. Traffic Loads. (indicate one) 1. Traffic loads anticipated .................................................. <br />2. No traffic loads......................................................... <br />Ccs- .. <br />J. Anchoring. Performed in accordance with installation instructions. 1. Deadmen.................................. <br />V. 2. Full slab ........................ ° .......... <br />Verified by: <br />A. Backfill mwerial bed is level and is a minimum of 12' deep. over native soil or slab. before setting tank .................. <br />3. Tank Spacing. Tanks are spaced correctly from each other and excavation walls according to instructions ................ <br />C. Visual Inspection. No evidence of damage found after setting in hole ............................................. <br />0. Straos and tie -downs oosition and secured according to installation instructions (wet hole) ........................... <br />E. Backfill Compacted. Material has been tamped and/or compacted to fill all voids around tank .......................... <br />F. Tank Properly ballasted during backfilling (wet hole installation only) ............................................ <br />G. Tank(s) buried at proper depth to conform to appropriate conditions. (wet. dry. traffic or not) ......................... <br />.' ' Verified by: <br />A. Physical Test. Air/soap test completed according to installation instructions ....................................... <br />B. Internal Measurement. The inside diameter of the tank has been measured and documented. (Dimension B Below) ........ <br />C. Brine Tanks: 1. Check and record brine level in the reservoir (inches) .................................. <br />2. Check for brine inside tank.............................................................. <br />All tanks must be measured to determine vertical deflection. Follow deflection measurement instructions in the installation manual. An initial <br />deflection measurement is taken and recorded as a point of reference. Subsequent measurements show tank deflection and can be compared to the <br />table below. Take each measurement from the same fitting using the same procedure. <br />TANK <br />NOMINAL INSIDE <br />ALLOWABLE <br />DIAMETER <br />DIAMETER <br />DEFLECTION <br />! (FT.) <br />SWT DWT -11 <br />(IN.) <br />� <br />» ! <br />48 48` <br />1:21:2' <br />6 I <br />71-3.8' 70-51' I <br />3,,-'- <br />91-116 40.5.8 ! <br />1.114' <br />118.112- I <br />t-1'2 <br />12 <br />136.5,3 — i <br />t•3.» <br />ACTUAL MEASUREMENTS <br />1.0. Before Backfilling (A) <br />I.D. After Backfilling (B) <br />DEFLECTIONS <br />(A) MINUS (81 _ <br />Verified By <br />END CENTER END <br />MARK THE LOCATION WHERE DEFLECTION <br />MEASUREMENTS WERE TAKEN. <br />
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