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COMPLIANCE INFO_2021
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231585
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COMPLIANCE INFO_2021
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Last modified
12/28/2021 11:11:58 AM
Creation date
1/19/2021 8:47:29 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231585
PE
2361
FACILITY_ID
FA0000174
FACILITY_NAME
JOES TRAVEL PLAZA
STREET_NUMBER
15600
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
LATHROP
Zip
95330
APN
19620079
CURRENT_STATUS
01
SITE_LOCATION
15600 S HARLAN RD
P_LOCATION
07
P_DISTRICT
003
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 <br />16. SENSOR TESTING RESULTS <br />List only sensors tested on date of this certification. List "Sensor ID" as labeled in system <br />programming. Additional copies of this page may be attached to accommodate all sensors tested. <br />Sensor lD <br />Sensor Model <br />Component(s) Monitored <br />Pass <br />Fail <br />L 1 <br />208 <br />DISP 1-2 <br />IX <br />❑ <br />L 2 <br />208 <br />DISP 3-4 <br />IX <br />❑ <br />L 3 <br />208 <br />DISP 5-6 <br />x <br />❑ <br />L 4 <br />208 <br />DISP 7-8 <br />x <br />❑ <br />L 5 <br />420 <br />87 ANNULAR <br />x <br />❑ <br />L 6 <br />420 <br />SPLIT TANK ANNULAR <br />N <br />❑ <br />L 7 <br />208 <br />87 EAST SUMP <br />ix <br />❑ <br />L 8 <br />208 <br />87 WEST SUMP <br />ix <br />❑ <br />L 9 <br />208 <br />91 SUMP <br />N <br />❑ <br />L 10 <br />208 <br />DIESEL FRONT SUMP <br />x <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />Describe all answers marked "No" or "Fail' and proposed remedy in Section 9. <br />List all monitoring equipment either replaced or repaired in Section 9 <br />Page 3 of 6 <br />
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