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COMPLIANCE INFO_2022
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231764
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COMPLIANCE INFO_2022
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Last modified
12/21/2022 8:37:49 AM
Creation date
6/3/2022 4:57:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0231764
PE
2361
FACILITY_ID
FA0002160
FACILITY_NAME
BlackHawk Petroleum Inc.
STREET_NUMBER
5611
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
08710052
CURRENT_STATUS
01
SITE_LOCATION
5611 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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Underground Storage Tank <br /> Monitoring System Certification Form <br /> 10. MONITORING SITE PLAN <br /> Date site plan was prepared: <br /> If a site plan has been prepared that shows all required information, you may include it, rather than this page, <br /> with your Monitoring System Certification Form. The site plan must show the general layout of tanks and <br /> identify locations of the monitoring panel, and all leak detection equipment and monitoring locations. Include <br /> a legend for all symbols depicted. <br /> SitpAddfem TIGER=XPRESS#2 DELTA SS_ 5nii E WATERLOO STOCKTON CA 95295 <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . A . . . . . . . . . . . . . . . . <br /> F <br /> T <br /> . . . . . . . . . . . . . . . . <br /> . . . . . _ . _ _ . _ <br /> TL 'PIPING f <br /> (iRi OWS) <br /> DT1%Vine at'pipina_ <br /> =Mt ca:sump aDd <br /> T I <br /> undeizroaud <br /> X X dram in accurate: <br /> use cauuet <br /> . . . . . . . . . . . . . . . . . . . - . . . . . . . . . Priata- 7 <br /> KEY <br /> A=AMLI-AX Senear <br /> . . . . . . . _ . . . F=FELLS <br /> V=3'-kFOR <br /> P=PRASE <br /> L=Iurbme'Leak Detector <br /> B=Brine Sensor <br /> 5=Smart Senaor <br /> C=Haar,&Chains <br /> E=E stop <br /> A*rferra rrr&rgrWffid1ha uraa reap 17SI 'a to erg a <br /> r,rq(esjjaw'QpdJRonapt-arrftresaI4fir rr orrraiio-rrilpvrpxxes. DrmsrrU <br /> not to seds <br /> dale rnap waa drawn:7121+2 <br /> Instructions <br /> if you already have a diagram that shows at required information,you may include it rather Than this page,With your Muniā¬oring Systern Certification. On yourske plan, <br /> shorrthe general layout of tanks and piping. Clearly identify locations of the Fallowing equipment,if installed:manib3 ing system cmrtrol panels;sensors manik ing tank <br /> annular spaces,sumps,dispenser pans,spill containers,or other secondary canramment areas.mechanical or ekmronk:line leak detectors;and in-tank liquid revel <br /> nrohes(if used for leak deaec*m). In the space provided,nate the date ihis Site Phn was prepafed. <br /> Page 6 of 6 <br />
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