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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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EHD - Public
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Healy Exhibit 8 <br /> Required Items in Conducting TP-201.3 <br /> (Executive Orders VR-201-M and VR-202-M) <br /> The instructions below are required when conducting TP-201.3 for these systems. The tester shall document that each step was <br /> followed as indicated below and shall include this page of the Exhibit with the submission of TP-201.3 test results. Note that <br /> districts may require use of an alternate form to meet these requirements, provided the alternate form includes the same <br /> minimum parameters. <br /> Prior to conducting TP-201.3, all four ball valves on the Healy Clean Air Separator(CAS)shall be closed, as shown in <br /> 1. Figure 1 or Figure 1 H, to isolate it from the Underground Storage Tank(UST)system to permit the pressurization of the <br /> UST system. Figure 1 applies to vertical CAS installations and Figure 1 H applies to horizontal CAS installations. <br /> 2 Conducting TP-201.3 with any dispenser piping test valve in the closed position is not permitted. Any dispenser with a <br /> dispenser piping test valve in the closed position while conduction TP-201.3 will bias the test towards compliance. <br /> After conducting TP-201.3, the four ball valces on the Healy Clean Air Seperator(CAS)shall be locked in their normal <br /> 3. operating positions as shown in Figure 213-2 or 213-21-1, Exhibit 2 of Executive Orders VR-201-M and VR-202-M. Figure 213- <br /> 2 applies to vertical CAS installations and Figure 213-21-1 applies to horizontal CAS installations. <br /> Required Steps Verification <br /> 1.All four CAS ball valves closed before conducting TP-201.3 Yes <br /> 2.All dispenser piping test valves open before conducting TP-201.3 Yes <br /> 3.All four CAS ball valves in normal operating positions after conducting TP-201.3 Yes <br /> Test Company: TANKNOLOGY INC. Facility Name: 7-ELEVEN #17334 MKT 2368(N-747) <br /> Tim Elebeck 1 A,-4� 7/27/2018 <br /> Print Name (Technician) Signature Date <br /> 8001435 1/26/2020 <br /> Technician Certification Number Expiration Date <br /> (ICC or District Training Certification,as applicable) <br /> Items Required in Conducting TP-201.3, Exhibit 8- Executive Orders VR-201-M and VR-202-M <br /> WO:2338028 <br />
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