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COMPLIANCE INFO_1998-2002
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231074
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COMPLIANCE INFO_1998-2002
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Last modified
3/1/2023 9:51:39 AM
Creation date
6/23/2020 6:40:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1998-2002
RECORD_ID
PR0231074
PE
2361
FACILITY_ID
FA0002541
FACILITY_NAME
7-ELEVEN INC #20632
STREET_NUMBER
4627
STREET_NAME
DA VINCI
STREET_TYPE
DR
City
STOCKTON
Zip
95207
APN
11002003
CURRENT_STATUS
01
SITE_LOCATION
4627 DA VINCI DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
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\MIGRATIONS\UST\UST_2361_PR0231074_4627 DA VINCI_1998-2002.tif
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EHD - Public
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Inalallallion. Ch'alklist <br />Jacketed Steel Underground Storage Tanks <br />Before the installation begins read the Installation Instructions thoroughly. As the tank installation pro- <br />gresses, initial each of the conditions below as each inspection is made. Failure to complete and <br />return this checklist shall prevent issuance of tank warranty. <br />The following information is to be completed by the Installation Supervisor. <br />Installation Date Steel Tank No.: Tank Jacket No.: <br />Tank Owner <br />Site Address <br />Installation Contractor Installation Supervisor <br />Verified by: <br />1. Handling: Lifting lugs were used and the tank was not damaged. <br />2. <br />Site Storage: No evidence of scrapes, holes, or drag marks found. <br />3. <br />Pro -installation Testing: (A) A 1 psi air -pressure soap test was done and no <br />evidence of leaks were found. Yes — No <br />(B) Tank was equipped with a vacuum indicator and maintained a continuous <br />vacuum prior to installation. Yes — No <br />All leaks discovered were repaired and the tank was re -tested. <br />4. <br />Bedding & Backfill: a. Sand—per specifications. <br />b. Pea Gravel—pee specifications. <br />c. Other - <br />5. <br />Excavation Size: Per our specification. <br />S. <br />Excavation Preparation: The hole is smooth and clean of debris. <br />7. <br />Backfilling: Backfilling was carefully supervised and no evidence that the Tank <br />Jacket was struck by the tamping bar. There was also no evidence that any <br />foreign debris fell into excavation. <br />8. <br />Anchoring: Hold down straps were used: Yes — No If yes, then <br />Strap Cushions were used under the hold down straps. <br />9. <br />Final Testing: A 2 psi air pressure hold test was performed before backfilling to <br />grade. <br />10. <br />Attaching Standpipe: Cross fitting was cemented to pipe. <br />After all the information above is com- <br />plete, detach and mail this Installation <br />Checklist to Total Containment, Inc. <br />using the pre -addressed. envelope pro- <br />vided. <br />TOTAL CONTAINMENT, INC. <br />15 East Uwchlan Avenue <br />Exton, Pennsylvania 19341 <br />
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