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COMPLIANCE INFO_2011-2013
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231125
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COMPLIANCE INFO_2011-2013
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Last modified
3/8/2021 3:02:45 PM
Creation date
6/23/2020 6:43:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2011-2013
RECORD_ID
PR0231125
PE
2361
FACILITY_ID
FA0003730
FACILITY_NAME
TIWANA GAS & FOOD
STREET_NUMBER
1210
Direction
E
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95210
APN
09403012
CURRENT_STATUS
01
SITE_LOCATION
1210 E HAMMER LN
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231125_1210 E HAMMER_2011-2013.tif
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EHD - Public
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11 <br />MO.# NW1-2308868 <br />Annie ATO CfAftation - WAY 20140 <br />,0 <br />Stc,,Z�q I <br />6. SENSORS (single well & double wall systems) <br />Location & <br />Product <br />• STO Sump <br />• ucc <br />• INTERSTITIAL <br />• FVRSunV <br />, Manufactum <br />o. HLS-, Beaudrami <br />o VLS VaedarRoot <br />o OTH 09w <br />Type <br />0 F Float <br />0 V V*pdr <br />o ND - Nonw <br />disavinatq-i, <br />0 D = D(aWdnaling. <br />Test Method <br />O S = S,UWWIAI0AAlarm <br />F - Flipp <br />0 :OTH btfi, <br />PRODUCT <br />BerletSfte <br />Adtivites 'SP*c""�: <br />Number I I Shutdown <br />YIN ymi . . <br />TOTAL <br />Shutdown <br />YIN <br />UL STP <br />VLS <br />ND <br />F <br />123456 Y N, <br />Y <br />UL L— 4x-9 <br />I -q <br />L-6 <br />I:D <br />iu D <br />4j <br />(AVACD tne rnni uut) <br />Comments: <br />7. PROBES Remove each vroduct level Probe and inspect for rust bioloalcal arovAh. etc. and clean if necessary <br />TANK# -OBSERVATIONS SERIAL NUMBER Fun tlkvEL WATER LEVEL <br />Tank # 1 <br />Tank * 2 <br />Tank #3 <br />Tank 0 4 <br />I certify that the Automatic Tank Gauging and/ r Leak Detection System is ope <br />accordance with the manufacturers' specifics ' nsf <br />Technician Name l,zz <br />Testing Company----J'Atj M)rxj� Date: <br />CIA <br />Address, A- Phone: <br />Fax: <br />/ATTACH COPY OFSYSTEM PROGRAMMING &TEST RESULTS <br />Page'3 of 3 <br />
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