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COMPLIANCE INFO_2022
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0232601
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COMPLIANCE INFO_2022
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Last modified
3/2/2022 8:37:00 AM
Creation date
1/14/2022 4:35:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0232601
PE
2361
FACILITY_ID
FA0004525
FACILITY_NAME
CHEVRON STATION #372736/2223
STREET_NUMBER
9484
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95210
APN
09055063
CURRENT_STATUS
01
SITE_LOCATION
9484 WEST LN
P_LOCATION
01
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 /> 7. LINE LEAK DETECTOR TESTING <br /> ❑ Check this box if line Ieak detectors ARE NOT installed. (Do not complete this section.) <br /> Simulated release rate verified: (Check all that apply.) Yes No NA <br /> A 3 GPH ❑ 0.1 GPH ❑ 0.2 GPH <br /> Has the testing apparatus been properly calibrated? A J J <br /> For emergency generator tank systems, does the LLD create an audible and visual D D R) <br /> alarm when a leak is detected? <br /> For mechanical LLDs, does the LLD restrict the flow through the pipe when a ❑ Lj <br /> release is detected? <br /> For electronic LLDs, does the turbine automatically shut off when a release is 21 Ll ❑ <br /> detected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the <br /> monitoring system is disabled or disconnected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the 0 J ❑ <br /> monitoring system malfunctions or fails a tightness test? <br /> For electronic LLDs, have all accessible wiring connections been visually inspected 23 ❑ ❑ <br /> for kinks and breaks? <br /> Were all items on the equipment manufacturer's maintenance checklist completed? A L] ❑ <br /> Were all LLDs confirmed operational within regulatory requirements? <br /> LLD ID LLD Morel Lines Monitored Pass Fail <br /> Q1 848480-001 SUP.PROD.LINE R1 Lj <br /> Q2 848480-001 REG.PROD.LINE 0 ❑ <br /> Q3 848480-001 DSL PROD.LINE ® ❑ <br /> ❑ Q <br /> ❑ Q <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ D <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> Q Q <br /> Describe all answers marked "No"or `Fail"and proposed remedy in Secrlon 9. <br /> List all monitoring equipment either replaced or repaired in Section 9 <br /> Page 4 of 6 <br />
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