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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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N
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99 (STATE ROUTE 99)
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25651
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2300 - Underground Storage Tank Program
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PR0231628
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
11/19/2024 1:51:19 PM
Creation date
4/30/2021 2:48:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231628
PE
2361
FACILITY_ID
FA0003835
FACILITY_NAME
SMK CHEVRON
STREET_NUMBER
25651
Direction
N
STREET_NAME
STATE ROUTE 99
City
ACAMPO
Zip
95220
APN
00514120
CURRENT_STATUS
01
SITE_LOCATION
25651 N HWY 99
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\kblackwell
Tags
EHD - Public
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25651 N HWY 99, Acampo Record ID PR0231628 <br /> 5/18/2021 UST Inspection <br /> Photo 1: The designated operator failed to check and note all required items on the visual inspection reports. The incorrect overfill test date <br /> was used on the reports. <br /> TANK ID T1: Regular ® ❑ T3: Diesei W ❑ <br /> T2: Premium ® ❑ ❑ ❑ <br /> Is the fill cap securely on the fill pipe? _ <br /> TANK ID T1: Regular EEEE]aO [1T3]- DieselT2: Premium ❑ ❑ <br /> Is the under-dispenser containment free of damage,water,debris,and hazardous substance? NA <br /> Under-dispenser Containment ID Y N N EUnder-dispenser Containment ID Y N <br /> 1/2 ® ❑ ❑ ❑ ❑ ❑ <br /> 314 ® ❑ ❑ ° <br /> 5/6 ® ❑ ❑ ❑ ° ❑ <br /> ❑ <br /> 71s ® ❑ ❑ a ❑ <br /> ❑ <br /> 9/10 ® ❑ ❑ ❑ ❑ <br /> ❑ <br /> 11112 ® 11 El ° ❑ <br /> ° ° <br /> Are all sensors in under-dispenser containment located to detect a leak at the earliest opportunity? D <br /> Y N NA DATE LAST <br /> X. TESTING AND MAINTENANCE PERFORMED <br /> Has the monitoring system certification been completed within the past 12 months? ® ❑ 514120 <br /> Has the spill container testing been completed within the past 12 months? ® ❑ 514120 <br /> Has the over-fill prevention equipment inspection been completed within the past 36 months? ® ❑ ❑ 6125119 <br /> Has the secondary containment testing been completed within the past 36 months? ® ❑ ❑ 619120 <br /> Has the tank tightness testing been completed within required bmeframes? ❑ ❑ <br /> Has the line tightness testing been completed within the required timeframes? ❑ ❑ <br /> Other re aired testin J maintenance was com leted within re aired timeframe. List test/maintenance Mems below. <br /> Test I Maintenance:Air Quality test 13 0 <br /> 13 [1 51412(} <br /> Test 1 Maintenance: <br /> Test/Maintenance: <br /> Test 1 Maintenance: <br /> Test 1 Maintenance: ❑ ❑ <br /> Test 1 Maintenance: ❑ � <br /> XI. FACILITY EMPLOYEE TRAINING Y N <br /> Have all individuals performing facility employee duties received the required facility employee training within the past 12 months? <br /> if the facility has more components than this form accommodates,additional copies of this page maybe attached. <br /> Y=Yes,N=No,NA=Not Applicable,tD=Identification <br /> f~ ' <br /> John Alaniz, REHS Page 1 of 4 <br />
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