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COMPLIANCE INFO_2021
Environmental Health - Public
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EHD Program Facility Records by Street Name
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VALPICO
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2300 - Underground Storage Tank Program
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PR0536555
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COMPLIANCE INFO_2021
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Last modified
12/29/2021 10:55:49 AM
Creation date
4/29/2021 10:35:37 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0536555
PE
2351
FACILITY_ID
FA0020989
FACILITY_NAME
Arco. Am pm 83333
STREET_NUMBER
550
Direction
W
STREET_NAME
VALPICO
STREET_TYPE
Rd
City
Tracy
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
550 W Valpico Rd
P_LOCATION
03
P_DISTRICT
005
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 />7. LINE LEAK DETECTOR TESTING <br />❑Check this box if line leak detectors ARE NOT installed. (Do not complete this section.) <br />Simulated release rate verified: (Check all that apply.) <br />x3 GPH 00.1 GPH00.2 GPH <br />Yes ' <br />No <br />' NA:':' <br />Has the testing apparatus been properly calibrated? <br />x <br />❑ <br />❑ <br />For emergency generator tank systems, does the LLD create an audible and visual alarm <br />when a leak is detected? <br />❑ <br />❑ <br />x <br />For mechanical LLDs, does the LLD restrict the flow through the pipe when a release is <br />detected? <br />Q3 <br />❑ <br />X <br />For electronic LLDs, does the turbine automatically shut off when a release is detected? <br />X <br />❑ <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring <br />system is disabled or disconnected? <br />X <br />❑ <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring <br />system malfunctions or fails a tightness test? <br />X <br />❑ <br />For electronic LLDs, have all accessible wiring connections been visually inspected for <br />kinks and breaks? <br />X <br />❑ <br />❑ <br />Were all items on the equipment manufacturer's maintenance checklist completed? <br />x <br />❑ <br />❑ <br />Were all LLDs confirmed operational within regulatory requirements? <br />x <br />❑ <br />❑ <br />LLD /D <br />LLD Model <br />Lines Monitored <br />Pass <br />Fail <br />01 <br />V/R 8484 <br />87 <br />X <br />❑ <br />Q2 <br />V/R 8484 <br />91 <br />X <br />❑ <br />Q3 <br />V/R 8484 <br />DIESEL <br />X <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 4 of 6 <br />
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