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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
Tags
EHD - Public
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LNWork Order Job : 339542 <br /> Contractor License: 485184 PO# : 3382477 <br /> Ref# : 3382477 <br /> Category : PM-Testing Unit# . 03 <br /> Component: Flow Rate Item ; TANK <br /> Failure: Verification Serial# : <br /> Repair: Passed Verification Task# : 7 <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 /> 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: with repairs <br /> Category : Tanks- Lines Unit# ; 03 <br /> Component: Fuel Item : TANK <br /> Failure : Sample Serial# : <br /> Repair: Picture Taken Task# : 8 <br /> Category: Tanks- Lines Unit# : 03 <br /> Component: Mech Leak Det. Item : TANK <br /> Failure: Slow Serial# : <br /> Repair: Replaced Same Model Task# : 9 <br /> Enter Datefrime 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 91 grade <br /> Details: MLD. Test ok. <br /> Category: PM -Testing Unit# : 03 <br /> Component; Flow Rate Item : TANK <br /> Failure: Verification Serial# : <br /> Repair: Passed w/ Repairs Task# : 10 <br /> Enter Date/Time of Service (Military Time): 10-254019 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 : with repairs <br /> i <br />: <br /> Report Date : 10/ 25/2019 3 : 13 : 54 PM PST Page 3 of 5 <br /> i <br />
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