My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
SR0082410
Environmental Health - Public
>
EHD Program Facility Records by Street Name
>
T
>
12 (STATE ROUTE 12)
>
13550
>
4200/4300 - Liquid Waste/Water Well Permits
>
SR0082410
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
11/19/2024 3:48:04 PM
Creation date
9/3/2020 2:37:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0082410
PE
4231
FACILITY_NAME
13550 HWY 12
STREET_NUMBER
13550
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95242
APN
05502002
ENTERED_DATE
7/31/2020 12:00:00 AM
SITE_LOCATION
13550 W HWY 12
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
171
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
APPENDIX E <br /> Tank Instail!ation Checklist <br /> TO INSTALLER:After tank installation,deliver the Installation Manual with the completed Tank Installation Checklist to the tank owner.Retain a copy <br /> of each for your records. <br /> TO OWNER:After installation,retain the limited warranty,the Installation Manual and completed Tank Installation Checklist for future reference and to <br /> facilitate any warranty claim. <br /> INSTALLATION DATE(S): PERSON COMPLETING FORM: <br /> INSTALLATION ADDRESS: <br /> TANK INFORMATION TANK#1 TANK#2 TANK#3 TANK#4 <br /> Tank type—Single-Wall(SW),Double-Wall(DW) <br /> Tank Usage(Fuel)—Fuel,DEF,Pipeline Sump <br /> Tank Usage(Water)—Potable Water,Water Collection <br /> Tank Usage(Wastewater)—Grease Interceptor,Septic, <br /> Industrial Wastewater/Chemical <br /> Tank Usage(Oil/Water Separator) <br /> Nominal Tank Diameter—give in feet <br /> Nominal Tank Capacity—give in gallons or liters(and note which) <br /> If applicable,UL/ULC#(read from tank label)—yes or no <br /> SITE INFORMATION(See section 1) TANK#1 TANK#2 TANK#3 TANK#4 <br /> Primary backfill meets Appendix C requirements—yes or no <br /> Secondary backfill material will be used—yes or no <br /> Secondary backfill meets our requirements—yes or no <br /> Geotextile will be used—yes or no <br /> Excavation—shored or not shored <br /> Tank will see traffic loads(H20 or HS20)—yes or no <br /> Hole condition—dry or wet <br /> Anchoring system will be used—yes or no <br /> If applicable,anchoring system used—deadmen or anchor slab <br /> JPREINSTALLATION INSPECTION AND TESTING(See sections 3 and 4) TANK#1 TANK#2 TANK#3 TANK#4 <br /> Shipping damage—yes or no <br /> Loss of vacuum—yes or no <br /> Monitoring fluid visible on interior of tank—yes or no <br /> Monitoring fluid visible on exterior of tank—yes or no <br /> Requirements met for double-wall tanks shipped under interstitial <br /> vacuum—yes or no <br /> Record fluid level in reservoir for double-wall wet tanks <br /> If required,tank passed pressure/soap test—yes or no <br /> ZCL° XERXES' 45 <br />
The URL can be used to link to this page
Your browser does not support the video tag.