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COMPLIANCE INFO_2023
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0527629
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
11/16/2023 7:49:36 AM
Creation date
5/4/2023 9:47:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0527629
PE
2351
FACILITY_ID
FA0018721
FACILITY_NAME
Costco Wholesale #1031
STREET_NUMBER
2440
STREET_NAME
DANIELS
STREET_TYPE
ST
City
MANTECA
Zip
95337
CURRENT_STATUS
01
SITE_LOCATION
2440 DANIELS ST
P_LOCATION
04
P_DISTRICT
005
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 /> C Check this box if line leak detectors ARE NOT installed. (Do not complete this section.) <br /> Simulated release rate verified: (Check all that apply.) Yes No NA <br /> 0 3 GPH Ej 0.1 GPH © 0.2 GPH <br /> Has the testing apparatus been properly calibrated? <br /> For emergency generator tank systems, does the LLD create an audible and visual <br /> alarm when a leak is detected? <br /> For mechanical LLDs, does the LLD restrict the flow through the pipe when a <br /> release is detected? <br /> For electronic LLDs, does the turbine automatically shut off when a release is <br /> detected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the FE-1 El El <br /> monitoring system is disabled or disconnected? <br /> For electronic LLDs, does the turbine automatically shut off if any portion of the <br /> monitoring system malfunctions or fails a tightness test? <br /> For electronic LLDs, have all accessible wiring connections been visually inspected <br /> for kinks and breaks? <br /> Were all items on the equipment manufacturer's maintenance checklist completed? E rl 0 <br /> Were all LLDs confirmed operational within regulatory requirements? Fff TE-11 <br /> LLD ID LLD Model Lines Monitored Pass Fail <br /> T-1 Veeder-Root PLLD Unleaded 87A M r] <br /> T-2 Veeder-Root PLLD Unleaded 87B M ❑� <br /> T-3 Veeder-Root PLLD Premium 91 F1 17 <br /> o a <br /> r] a <br /> ri ri <br /> 17 17 <br /> rl <br /> ri o <br /> 17 <br /> Describe all answers marked "No"or "Fail'and proposed remedy in Section 9. <br /> List all monitoring equipment either replaced or repaired in Section 9 <br /> Page 4 of 6 <br />
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