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COMPLIANCE INFO_2023
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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PR0231413
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COMPLIANCE INFO_2023
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Last modified
11/16/2023 1:56:58 PM
Creation date
7/19/2023 8:52:25 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0231413
PE
2361
FACILITY_ID
FA0003122
FACILITY_NAME
QUIK STOP MARKET #138
STREET_NUMBER
1153
STREET_NAME
LINCOLN
STREET_TYPE
BLVD
City
TRACY
Zip
95376
APN
231-190-12
CURRENT_STATUS
01
SITE_LOCATION
1153 LINCOLN BLVD
P_LOCATION
03
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 />7 Check this box if line leak detectors ARE NOT installed. (Do not complete this section.) <br />Simulated release rate verified: (Check all that apply.) <br />© 3 GPH r] 0.1 GPH © 0.2 GPH <br />Yes <br />No <br />NA <br />Has the testing apparatus been properly calibrated? <br />© <br />© <br />El <br />For emergency generator tank systems, does the LLD create an audible and visual <br />alarm when a leak is detected? <br />r] <br />© <br />0✓ <br />For mechanical LLDs, does the LLD restrict the flow through the pipe when a <br />release is detected? <br />VMI 99LD-2000 <br />91 Product <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 <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 />© <br />0 <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? <br />® <br />Were all LLDs confirmed operational within regulatory requirements? <br />LLD ID LLD Model <br />Lines Monitored <br />Pass <br />Fail <br />87 N <br />VMI 99LD-2000 <br />87 North Product <br />©âœ“ <br />0 <br />87S <br />VMI 99LD-2000 <br />87 South Product <br />®âœ“El <br />91 <br />VMI 99LD-2000 <br />91 Product <br />® <br />0 <br />© <br />0 <br />0 <br />0 <br />0 <br />0 <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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