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COMPLIANCE INFO_2021
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231497
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COMPLIANCE INFO_2021
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Last modified
1/25/2022 10:43:11 AM
Creation date
11/10/2021 8:23:42 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231497
PE
2361
FACILITY_ID
FA0000279
FACILITY_NAME
ESCALON MINI MART
STREET_NUMBER
1097
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
ESCALON
Zip
95320
APN
22510001
CURRENT_STATUS
01
SITE_LOCATION
1097 YOSEMITE AVE
P_LOCATION
99
P_DISTRICT
004
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 /> 8 . IN-TANK GAUGING TESTING <br /> ❑ Check this box if tank gauging is used only for inventory control . <br /> ❑ Check this box if NO tank gauging equipment is installed . Yes No ' NA <br /> Do not complete this section if either box is checked. <br /> All wiring has been : 1 ) visually inspected for kinks , breaks and proper entry and ❑ ❑ ❑ <br /> termination ; and 2 tested for ground faults? <br /> Were all in-tank gauging probes visually inspected for damage and residue buildup ® ❑ ❑ <br /> to ensure that floats move freely, functionally tested , and confirmed o erationaP <br /> Was accuracy of system ' s product level readings tested ? ❑ <br /> Was accuracy of system 's water level readings tested ? ❑ <br /> Were all probes reinstalled properly? ❑ ❑ ❑ <br /> Were all items on the equipment manufacturer's maintenance checklist completed ? ® ® 1 ❑ <br /> Probe ID Probe Model Tanks Monitored PassFail <br /> ❑ ❑ <br /> ❑ ❑ <br /> 9 . COMMENTS <br /> Describe all answers marked "No" or "Fail" and proposed remedy. <br /> List all monitoring equipment either replaced or repaired. <br /> S .rre FNvrorzD (- .rgvrll scoso \L ) 4Ch-4JeD f' w 'O Zz'rL cFD 5F, N3, \V <br /> r) rfl warEr resr , c. ovse $ Ntb%L Avn) SrrK � dou IJrsp 7 • g , <br /> Page 5 of 6 <br />
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