My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
COMPLIANCE INFO_2016-2017
Environmental Health - Public
>
EHD Program Facility Records by Street Name
>
J
>
JACK TONE
>
1501
>
2300 - Underground Storage Tank Program
>
PR0505264
>
COMPLIANCE INFO_2016-2017
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/11/2021 8:36:01 AM
Creation date
6/23/2020 6:57:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2016-2017
RECORD_ID
PR0505264
PE
2361
FACILITY_ID
FA0006672
FACILITY_NAME
FLYING J TRAVEL PLAZA #618*
STREET_NUMBER
1501
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
22811017
CURRENT_STATUS
01
SITE_LOCATION
1501 N JACK TONE RD
P_LOCATION
05
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0505264_1501 N JACK TONE_2016-2017.tif
Tags
EHD - Public
Jump to thumbnail
< previous set
next set >
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
344
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
I. Results of Vacuum/Pressure Monitoring Equipment Testing <br /> This page should be used to document testing and servicing of vacuum and pressure interstitial sensors. A copy of this form must <br /> be included with the Monitoring System Certification Form, which must be provided to the tank system owner/operator. The <br /> owner/operator must submit a copy of the Monitoring System Certification Form to the local agency regulating UST systems <br /> within 30 days of test date. <br /> Model:TLS 350 System Type: ❑ Pressure;❑✓ Vacuum <br /> 1 Component(s)Monitored by this Sensor: BIO-Diesel B-99 <br /> Sensor Functionality Test Result:Q Pass; ❑ Fail Interstitial Communication Test Result: ® Pass; ❑ Fail <br /> 2 Component(s)Monitored by this Sensor: 19-20 Product <br /> L Sensor Functionality Test Result:®Pass; ❑ Fail Interstitial Communication Test Result: ❑# Pass; ❑ Fail <br /> S3Component(s)Monitored by this Sensor: 21-30 Product <br /> Sensor Functionality Test Result:❑X Pass; ❑ Fail Interstitial Communication Test Result: ®Pass; ❑ Fail <br /> Component(s)Monitored by this Sensor: <br /> Sensor Functionality Test Result:❑Pass; ❑ Fail Interstitial Communication Test Result: ❑Pass; ❑ Fail <br /> Component(s)Monitored by this Sensor: <br /> Sensor Functionality Test Result:❑Pass; ❑ Fail Interstitial Communication Test Result: ❑Pass; ❑ Fail <br /> Component(s)Monitored by this Sensor: <br /> Sensor Functionality Test Result:❑Pass; ❑ Fail Interstitial Communication Test Result: ❑ Pass; ❑ Fail <br /> Component(s)Monitored by this Sensor: <br /> Sensor Functionality Test Result: ❑Pass; ❑ Fail Interstitial Communication Test Result: ❑ Pass; ❑ Fail <br /> Component(s)Monitored by this Sensor: <br /> Sensor Functionality Test Result: ❑Pass; ❑ Fail Interstitial Communication Test Result: ❑Pass; ❑ Fail <br /> Component(s)Monitored by this Sensor: <br /> Sensor Functionality Test Result:❑Pass; ❑ Fail Interstitial Communication Test Result: ❑ Pass; ❑ Fail <br /> Component(s)Monitored by this Sensor: <br /> Sensor Functionality Test Result:❑Pass; ❑ Fail Interstitial Communication Test Result: ❑ Pass; ❑ Fail <br /> How was interstitial communication verified? <br /> El Leak Introduced at Far End of Interstitial Space;' ❑ Gauge; ❑ Visual Inspection; ❑ Other(Describe in Sec.J, <br /> below <br /> Was vacuum/pressure restored to operating levels in all interstitial spaces? ®Yes ❑No(If no, describe in Sec.J, below) <br /> J. Comments(500 characters max.use additional sheets if needed): <br /> ' If the sensor successfully detects a simulated vacuum/pressure leak introduced in the interstitial space at the furthest point from the <br /> sensor,vacuum/pressure has been demonstrated to be communicating throughout the interstice. <br /> Page 4 of <br />
The URL can be used to link to this page
Your browser does not support the video tag.