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COMPLIANCE INFO_2020
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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KETTLEMAN
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2300 - Underground Storage Tank Program
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PR0231906
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
11/3/2021 4:04:16 PM
Creation date
1/17/2020 11:55:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0231906
PE
2361
FACILITY_ID
FA0003776
FACILITY_NAME
KWIK SERV LODI BW 113*
STREET_NUMBER
420
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06202042
CURRENT_STATUS
01
SITE_LOCATION
420 W KETTLEMAN LN
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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CgE I Work order Job : 339542 <br /> Contractor License : 485184 PO# : 3382477 <br /> Ref#: 3382477 <br /> Category: PM -Testing Unit# : 01 <br /> Component: Flow Rate Item : GIL ENCORE 700 NN - 1 <br /> Failure : Verification Serial # : EN00003232 <br /> Repair: Passed w/ Repairs Task# : 3 <br /> Enter Datefflme of Service (Military Time): 10-25-2019 08: 00 The following data was recorded by (Tech Mike Smith <br /> First/Last Name): <br /> Update Site Maintenance and ISD Logs, TAKE COMPLETE Name of person site keys returned to or Did Did not use <br /> PICTURES and attach to job: Not Use: <br /> The status of this task is : CLOSED - COMPLETE Brief Summary of Repairs or Additional Flow rate test passed <br /> Details : after repairs. <br /> Category : Tanks-Lines Unit# : 03 <br /> Component: Check Valve Item : TANK <br /> Failure: Damaged-Worn Serial# : <br /> Repair : Replaced Same Model Task# : 5 <br /> Enter Date/Time of Service (Military Time) : 10.25.2019 08 : 00 The following data was recorded by (Tech Mike Smith <br /> First/Last Name): <br /> Reviewed Site Maintenance Log AND Alert COMPLETE Issue reported is for grade: PREMIUM <br /> Service History for recent service : <br /> Confirmed Sensor(s) in lowest position : CONFIRMED Waste Disposal left on site: MISC HARDWARE <br /> Attached picture of waste drum label with an ON SITE SUPPLIED While addressing this task I created and No alarms created <br /> accumulation date clearly written : DRUM cleared the following new Monitoring System <br /> alarm (s): <br /> Update Site Maintenance Log , TAKE COMPLETE Name of person site keys returned to OR Did Did not use <br /> PICTURE and attach picture to job : Not Use: <br /> The status of this task is : CLOSED - COMPLETE Brief Summary of Repairs or Additional Replaced damaged 1 <br /> Details: worn check valve on <br /> 91 grade <br /> Category: Tanks-Lines Unit# : 03 <br /> Component: Turbine Motor Item : TANK <br /> Failure: Slow Serial# : <br /> Repair: Replaced SubAssy Task# : 6 <br /> Enter Date/Time of Service ( Military Time): 1045.2019 08 : 00 The following data was recorded by (Tech Mike Smith <br /> First/Last Name): <br /> Reviewed Site Maintenance Log AND Alert COMPLETE Issue reported is for grade: PREMIUM <br /> Service History for recent service: <br /> Confirmed Sensor(s) in lowest position: CONFIRMED Waste Disposal left on site : MISC HARDWARE <br /> Attached picture of waste drum label with an ON SITE SUPPLIED While addressing this task I created and No alarms created <br /> accumulation date clearly written : DRUM cleared the following new Monitoring System <br /> alarm (s): <br /> Update Site Maintenance Log , TAKE COMPLETE Name of person site keys returned to OR Did Did not use <br /> PICTURE and attach picture to job: Not Use: <br /> The status of this task is: CLOSED - COMPLETE Brief Summary of Repairs or Additional Replaced 91 grade <br /> Details: MLD. Test ok. <br /> Report Date : 10/ 25/2019 3 : 13 : 54 PM PST Page 2 of 5 <br /> l <br />
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