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INSTALL_2022
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0547762
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INSTALL_2022
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Last modified
8/26/2025 10:48:13 AM
Creation date
7/6/2022 9:54:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
2022
RECORD_ID
PR0547762
PE
2351
FACILITY_ID
FA0027204
FACILITY_NAME
SAFEWAY FUEL CENTER #0055
STREET_NUMBER
19533
Direction
S
STREET_NAME
MOUNTAIN HOUSE
STREET_TYPE
PKWY
City
MOUNTAIN HOUSE
Zip
95391
CURRENT_STATUS
01
SITE_LOCATION
19533 S MOUNTAIN HOUSE PKWY
QC Status
Approved
Scanner
SJGOV\kblackwell
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EHD - Public
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TANK INSTALLATION CHECKLIST <br /> Record tank diameter measurement#1:(before installation) <br /> N <br /> Record final backfill bedding depth under tank-inches or centimeters I !' <br /> Record final tank spacing between tanks-inches or centimeters 51( ri� ' ��° (oil <br /> Record final tank spacing from tank endcap to excavation walls-inches �� (� e�� Apo...or centimeters <br /> If applicable,deadmen used-factory-supplied or other <br /> If applicable,anchorin�ghardware-fiactor -su liedorother <br /> Record diameter measurement#2(after straps are installed) I 2SY4 <br /> Subtract diameter measurement#2 from#1 and record ,0 t <br /> Deflection measurement meets Table 1.6 requirements-yes or no <br /> Voids under tank between ribs and under dome�.filled with backfill <br /> and tamped-yes or no V� <br /> Backfill placement and compaction meet requirements-yes or no <br /> Piping connections meet requirements-yes or no <br /> Fittings and other metal components are coated for corrosion <br /> protection - yes or no <br /> Record diameter measurement#3(after backfilling to top of tank is 0 <br /> complete) � 1 7 � 13 <br /> Subtract diameter measurement#3 from#1 and record lie <br /> Deflection measurement meets Table 1-6 requirements-yes or no <br /> Tank was ballasted prior to bringing backfill to top oftank-yes or no rl�j15 v <br /> After backfilling is brought to top of tank(See Sections 5,6 and 8) <br /> Tank was ballasted after bringing backfill to top oftank-yes or no <br /> Postinstallation tests were conducted for pressure-testable tanks-'yes <br /> or no N ��j �S \./Lim <br /> If applicable,optional hydrostatic test was performed-yes or no .b ^U <br /> If applicable,containment sump test was successful-yes or no <br /> Record final depth of backfill overtank-give in inches or centimeters `�'0 ff <br /> Record diameter measurement#4(after backfilling is brought to <br /> subgrade) Vi <br /> �` �� �� l�.� <br /> Subract diameter measurement#4 from#1 and record <br /> Final deflection measurement meets requirements of Table 1-6-yes <br /> or no <br /> Awl <br /> If applicable,type of surface pad used-concrete or asphalt Lu� <br /> If applicable,thickness of surface pad used-give in inches or .q.%.k T6.11 <br /> centimeters and note which type <br /> If applicable,record monitoring fluid level when backfilling&top slab iI <br /> installation are complete <br /> 38 KA ES° <br /> BY SHAWCOR <br />
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