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COMPLIANCE INFO_2021
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231906
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COMPLIANCE INFO_2021
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Last modified
1/12/2022 4:38:57 PM
Creation date
1/11/2021 9:57:54 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231906
PE
2361
FACILITY_ID
FA0003776
FACILITY_NAME
KWIK SERV LODI BW 113*
STREET_NUMBER
420
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06202042
CURRENT_STATUS
01
SITE_LOCATION
420 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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0. Results of TestinglServicing <br /> Software Version Installed: 329.03 <br /> Complete the following checklist; <br /> ® Yes ❑ No* Is the audible alarm operational? <br /> ® Yes ❑ No* Is the visual alarm operational? <br /> • Yes ❑ No* Were all sensors visually inspected,functionatly tested,and confirmed operational? <br /> ® Yes ❑ No* Were all sensors installed at lowest paint of secondary containment and positioned so that other equipment will not interfere with their proper <br /> operation? <br /> ❑ Yes ❑ No, if alarms are relayed to a remote monitoring station,is all communications equipment(e.g.,modem)operational? <br /> ® NIA <br /> ® Yes © No* For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak, <br /> © N/A fails to operate, or is electricaily disconnected? If yes: which sensors initiate positive shut-down? (Check all Thad apply) N Sump/Trench <br /> Sensors; ®Dispenser Containment Sensors. <br /> Olid you confirm positive shut-down due to leaks and sensor failure/disconnection? ®Yes; ❑No. <br /> ❑ Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.,no mechanical overfill prevention valve is <br /> ® NIA installed),is the overfill warning alarm visible and audible at the tank fill point(s)and operating properly? if so,at what percent of tank capacity <br /> does the alarm trigger? % <br /> ❑ Yes ® No Was any monitoring equipment replaced? if yes,identify specific sensors,probes,or other equipment replaced and list the manufacturer name <br /> and model for all replacement pans in Section E,below. <br /> ❑Yes* ® No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) <br /> ❑Product; ❑Water. If yes,describe causes in Section E,below. <br /> ® Yes El No* Was monitoring system set-up reviewed to ensure proper settings?Attach set up reports,if applicable <br /> ® Yes ❑ No* Is all monitoring equipment operational per manufacturer's specifications? <br /> *In Section E below,describe how and when these deficiencies were or will he corrected. <br /> E. Comments: <br /> Monitoring Systern Certification Page 2 of 4 2/21/07 <br />
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