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COMPLIANCE INFO_2020
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231233
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COMPLIANCE INFO_2020
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Last modified
11/25/2020 2:29:11 PM
Creation date
9/11/2020 2:54:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0231233
PE
2361
FACILITY_ID
FA0002479
FACILITY_NAME
7-ELEVEN INC #17334
STREET_NUMBER
4501
Direction
N
STREET_NAME
PERSHING
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
11017004
CURRENT_STATUS
01
SITE_LOCATION
4501 N PERSHING AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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UNDERGROUND STORAGE TANK <br /> MONITORING SYSTEM CERTIFICATION FORM (Page 5 of 6) <br /> XVI . LINE LEAK DETECTOR TESTING <br /> r Check this box if line leak detectors (LLD) are NOT installed . (Do not complete this section.) Y N NA <br /> This section must be completed if LLDs are installed . <br /> Was a leak simulated to verify LLD performance? (— <br /> Check all that apply.) Simulated leak rate verified : 3 GPH r 1 . 1 GPH r 0 . 2 GPH <br /> Was the testing apparatus properly calibrated? r <br /> For emergency generator tank systems , does the LLD create an audible and visual alarm when a leak is detected ? r r Iw <br /> For mechanical LLDs , does the LLD restrict the flow through the pipe when a leak is detected ? r <br /> For electronic LLDs , does the turbine automatically shut off when a leak is detected ? r r <br /> For electronic LLDs , does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br /> For electronic LLDs , does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? r <br /> For electronic LLDs , have all accessible wiring connections been visually inspected for kinks and breaks? r r <br /> Were all items on the equipment manufacturer's maintenance checklist completed ? <br /> Were all LLDs confirmed operational within regulatory requirements? r r r <br /> For any answer of "N" above, describe in section Xlll how and when these issues were or will be corrected. <br /> XIII . COMMENTS <br /> Replaced 87 reg leak detector, Due to a bad LD . Replaced it with an LD-2000 and passed . <br /> XIV VACUUM / PRESSURE/ HYDROSTATIC MONITORING EQUIPMENT TESTING <br /> W Check this box if VPH monitoring is NOT used . (Do not complete this section .) <br /> This section must be completed if VPH monitoring is used to perform leak detection monitoring . <br /> System Type Mark all that apply ,) rVacuum r Pressure r H drostatic <br /> Sensor ID Component(s) Monitored by this Sensor Sensor Functionality Interstitial Communication <br /> Test Test <br /> r Pass r Fail r Pass r Fail <br /> r Pass r Fail r Pass r Fail <br /> r Pass r Fail r Pass r Fail <br /> I" Pass r Fail r Pass r Fail <br /> r Pass r Fail r Pass r Fail <br /> r Pass r Fail r Pass r Fail <br /> r Pass r Fail r Pass r Fail <br /> r Pass r Fail r Pass r Fail <br /> r Pass r Fail r Pass r Fail <br /> r Pass r Fail r Pass r Fail <br /> i <br /> r Pass r Fail r Pass r Fail <br /> j r Pass r Fail r Pass r Fail <br /> E How was interstitial communication verified ? r Simulated leak at far ends of the interstitial space . r Visual Inspection <br /> F Other Describe the method in section XV below.) r Gauge <br /> Was the vacuum or pressure restored to operating levels in all interstitial spaces? r Yes r No (Describe the reason in section XV below.) <br /> For any answer of 'W " above, describe in section X111 how and when these issues were or will be corrected. <br /> XV. COMMENTS <br /> GPH = Gallons per hour, Y = Yes , N = No , NA = Not applicable, VPH = Vacuum /Pressure/ Hydrostatic, ID = Identification <br />
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