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COMPLIANCE INFO_2020
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231223
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COMPLIANCE INFO_2020
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Last modified
12/31/2020 8:09:56 AM
Creation date
5/19/2020 3:38:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0231223
PE
2361
FACILITY_ID
FA0002324
FACILITY_NAME
Pacific Service Station
STREET_NUMBER
6131
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
09746418
CURRENT_STATUS
01
SITE_LOCATION
6131 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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=v <br /> h <br /> UNDERGROUND STORAGE TANK A [J 1 0 <br /> SECONDARY CONTAINMENT TESTING REPORT FORM ( Page 4 of 6) <br /> XIII . VAPOR RECOVERY PIPING CONTAINMENT TESTIN - I a <br /> Manufacturer Identi Tank ID from Section III for each Manufacture -- r o s r t � .� . [ ° s <br /> ❑ C <br /> B ❑ ❑ - <br /> AD ❑ <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify) : <br /> ❑ Industry Code or Engineering Standard (Specify) : <br /> ❑ Engineered Method (Specify): <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. <br /> Vapor Recovery Piping Containment Testing Training and Certifications (List applicable certifications) Expiration Date <br /> Interstitial Communication Verification Method Used : <br /> XIV. COMMENTS <br /> Provide any additional comments here. <br /> NA-Section llkNo Vapor Recovery Piping Containment at this UST Facility . <br /> XV. TURBINE / PRODUCT PIPING SUMP TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Unknown Fiber lass A ❑x B C ❑x D ❑ <br /> A ❑ I B ❑ I C D ❑ <br /> Test Method Used : [I Manufacturer Guidelines (Specify): <br /> ❑ Industry Code or Engineering Standard (Specify) : <br /> M Engineered Method (Specify): Caldwell Systems/ Hydrostatic 30 Minutes <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. 2 <br /> Turbine / Product Piping Sump Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> Caldwell Level Change Indicator 7/5/2020 <br /> ICC Service Technician #5246802 - UT 3/20/2021 <br /> Underground Storage Tank Tester License #90 - 1120 12/31 /2019 <br /> XVI . COMMENTS <br /> Provide any additional comments here. <br /> ID = Identification <br />
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