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COMPLIANCE INFO_2020
Environmental Health - Public
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EHD Program Facility Records by Street Name
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P
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PICCOLI
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1990
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2300 - Underground Storage Tank Program
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PR0231820
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COMPLIANCE INFO_2020
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Last modified
3/8/2021 9:27:37 AM
Creation date
6/18/2020 9:46:15 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0231820
PE
2361
FACILITY_ID
FA0003826
FACILITY_NAME
Supervalu
STREET_NUMBER
1990
Direction
N
STREET_NAME
PICCOLI
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
10121001
CURRENT_STATUS
01
SITE_LOCATION
1990 N PICCOLI RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Underground Storage Tank <br />Designated UST Operator Visual Inspection Report <br />5. OWNER/OPERATOR DESCRIPTION OF FOLLOW-UP ACTION <br />Number the follow up actions to correspond to appropriate compliance issues from Section 3. <br />N/A <br />6. OWNER / OPERATOR ACKNOWLEDGEMENT OF INSPECTION RESULTS <br />I have reviewed the results of the designated UST operator inspection report and provided a <br />description of the action(s) taken or to be taken to correct any compliance issues discovered. <br />Name of UST Owner / Operator (print) Erik Brown <br />UST Owner/Operator Signature Date Signed <br />12/4/20 <br />7. INSPECTION HISTORY <br />Has each follow-up action of Section 3 from the previous Designated UST <br />Operator Inspection Report been completed appropriately? <br />(Attach documentation verifying appropriate service to this report.) <br />Yes <br />In <br />No <br />ii <br />NA <br />In <br />8. RELEASE DETECTION ALARM HISTORY <br />Attach a copy of the alarm history report/log to this report. Yes No NA <br />Is the monitoring system powered on and in proper operating mode? III r <br />Has each alarm since the previous inspection been responded to appropriately? <br />(Attach documentation verifying appropriate service to this report.) <br />I n ri <br />Have all containment sumps, that have had an alarm since the previous <br />designated UST operator inspection report, been responded to by a qualified <br />service technician? <br />J Iii 7 <br />All answers marked "No" must be described by the designated UST operator in Section 3. <br />Page 2 of 4
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