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COMPLIANCE INFO_2022
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0231309
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COMPLIANCE INFO_2022
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Last modified
12/21/2022 7:52:38 AM
Creation date
9/2/2022 9:37:42 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0231309
PE
2361
FACILITY_ID
FA0003756
FACILITY_NAME
KISHIDA, GEORGE INC
STREET_NUMBER
1725
STREET_NAME
ACKERMAN
STREET_TYPE
DR
City
LODI
Zip
95240
APN
06219001
CURRENT_STATUS
01
SITE_LOCATION
1725 ACKERMAN DR
P_LOCATION
02
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 in-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 operational? <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? ❑ ❑ ❑ <br /> Probe ID Probe Model Tank Monitored Pass Fail <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> ❑ ❑ <br /> 9. COMMENTS <br /> Site has no positive shut down. <br /> Precision line test performed. <br /> Page 5 of 7 <br />
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