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COMPLIANCE INFO_2020
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0518738
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COMPLIANCE INFO_2020
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Last modified
7/6/2022 1:20:33 PM
Creation date
7/6/2020 1:23:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0518738
PE
2361
FACILITY_ID
FA0014111
FACILITY_NAME
CHEVRON STATION #212470/2222*
STREET_NUMBER
3400
STREET_NAME
MACARTHUR
STREET_TYPE
DR
City
TRACY
Zip
95376
APN
21306016
CURRENT_STATUS
01
SITE_LOCATION
3400 MACARTHUR DR
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
KBlackwell
Tags
EHD - Public
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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM (Page3of6) <br /> Monitoring Device Used Device Model# Monitoring Device Used Device Model# <br /> VENT I TRANSITION SUMP ID: Vent Sump VENT i TRANSITION SUMP ID: <br /> ®Sump Sensor VR 794380-209 ❑Sump Sensor <br /> ❑VPH Sensor ❑VPH Sensor <br /> UDC ID: 01-02 UDC ID: 03-04 <br /> m Electronic Sensor VR 794380-208 ®Electronic Sensor VR 794380-208 <br /> ❑Mechanical Device ❑Mechanical Device <br /> ❑VPH Sensor ❑VPH Sensor <br /> UDC ID: 05-06 UDC ID: 07-08 <br /> 0 Electronic Sensor VR 794380-208 ®Electronic Sensor VR 794380-208 <br /> ❑Mechanical Device ❑Mechanical Device <br /> ❑VPH Sensor ❑VPH Sensor <br /> UDC ID: UDC ID: <br /> ❑Electronic Sensor ❑Electronic Sensor <br /> ❑Mechanical Device ❑Mechanical Device <br /> ❑VPH Sensor ❑VPH Sensor <br /> UDC ID: UDC ID: <br /> ❑Electronic Sensor ❑Electronic Sensor <br /> ❑Mechanical Device ❑Mechanical Device <br /> ❑VPH Sensor ❑VPH Sensor <br /> Other Monitored Component ID: Other Monitored Component ID: <br /> ❑Other(Specify in section V11.) ❑Other(Specify in section Vll.) <br /> Other Monitored Component ID: Other Monitored Component ID: <br /> ❑Other(Specify in section VII.) ❑Other(Specify in section VII.) <br /> Other Monitored Component ID: Other Monitored Component ID: <br /> ❑Other(Specify in section V11.) I ❑Other(Specify in section VII.) <br /> Include Information for every underground storage tank component monitored by this monitoring system control panel. If the monitoring system <br /> control panel monitors more components than this fonn accommodates additional copies of these pages mey be attached. <br /> VII. COMMENTS <br /> Use this section to provide additional comments about the inventory of the equipment certified. <br /> Estops-Tested& Passed. <br /> Shear Valves-Tested& Passed. <br /> Diesel & 91 are Split Tank&Share Annular. <br /> ID=Identification,VPH=Vacuum Pressure/Hydrostatic,UDC=Under-Dispenser Containment <br />
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