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COMPLIANCE INFO_1986-2006
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231331
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COMPLIANCE INFO_1986-2006
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Last modified
6/20/2023 9:32:19 AM
Creation date
6/3/2020 9:43:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1986-2006
RECORD_ID
PR0231331
PE
2351
FACILITY_ID
FA0000513
FACILITY_NAME
LODI MEMORIAL HOSPITAL
STREET_NUMBER
975
Direction
S
STREET_NAME
FAIRMONT
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
03107039
CURRENT_STATUS
01
SITE_LOCATION
975 S FAIRMONT AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2351_PR0231331_975 S FAIRMONT_1986-2006.tif
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EHD - Public
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14- <br /> Name of Supplier.Owner of Address No.and fs) city a est <br /> 15a. BRIEF DIAGRAM OF TANK FIELD 16. CAPACITY <br /> From <br /> 15. TANK TO TEST. ❑ Station Chart <br /> PJom final ay Woo. ❑ Tank <br /> M*MKGC"PW'o Chart <br /> / identity tty Position Gallons [::�- a <br /> e "t BY moot am"" ❑ Charts supplied with <br /> f Brand and Grafi RY chart smel able ❑ Other <br /> Gdkfr� <br /> Taal <br /> 17. FILL-UP FOR TEST Gams «.Pending <br /> S"vftw ttan (/ <br /> amore Fl"-up in. in. Inventory �" <br /> to§t" Gallons Tank otometer <br /> r. <br /> 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK ❑wow in tank ® Line(s)being tested with I.VUJ <br /> Sae annual sections applicable.Check below and record procedure In kg(27). ❑High water table In tank esCratkm <br /> Can <br /> Transfer total to lane <br /> LiveLivemaximum ofIowaMe test pressure tor all testa. <br /> 19. TANK MEASUREMENTS FOR <br /> Four pound rue not y to do ublewened tanks. TSTT ASSEMBLY '' El stage It <br /> 21. VAPOR RECOVERY SYSTEM ❑� i <br /> Complete section below: Bottom of tank to grade'............................ In. <br /> Add 3g"for"r probe ........................... 30 In. 241). COEFFICIENT OF EXPANSION <br /> i. Is Pow pound rule required? Yea ❑ No ❑ Total W"to ensemble—approximate,............._J-12-Lin. RECIPROCAL METHOD <br /> Typeof Product ........................................ <br /> < 20. EXTENSION HOSE SETTING R <br /> 2.Haight to/2"mark from bottom of tank In. _3,5 in. Hy E ................. H <br /> Tank top to grade'............ ................. <br /> T In Truk <br /> r �, '`� trek tn,�...................................... in.hoes on auction puffs a"of mote ® ¢F <br /> 3. at bottom of tank � _P.S,I. After Circulation........................................ <br /> below Temperaturea ................................. •F <br /> 1 d f t C 'if Fill pipe above ,use top of till. <br /> 4 rot at top of tank P.S.1. <br /> 22. TMrmal-sensor reading alta circulation 12za Difference(+r-)......................................... <br /> di I it <br /> Depth of burisl 3_� In. F Observed A.P.I.Gravity ...............®................ <br /> Between <br /> 23. Pions par.F In range of ed change 0 Rx —IeL— <br /> ®/ <br /> Tank dle. ,QJ In. digits cd' ° <br /> COEFFICIENT OF EXPANSION (Complete atter circulation) <br /> Taal quantity in Reciprocal volume Change in <br /> 24a. Corrected A.P.I.Gravity fun tank(III or 47) this tank per'F <br /> VMr Mae M. Observed A.P.I.Grwlty................................... Transferto L <br /> ine Mo. <br /> NOTES: <br /> Hydrometerem ................................... H <br /> Observed sampla Temperature ......................... •F <br /> 24c. FOR TESTING WITH WATER am Tobit,c a o <br /> Corrected A.P.I.Gravity T �t <br /> (0�•F.From Table A.................................... Table C.........................................r...... •F <br /> Coefficient of Expansion or vftw <br /> The gbonat Cliteulaffeing ars to be used for dry coil condition•to for Involved Product Table D................................................ <br /> estabillsho posit"p rot nt ,owhon using the four pound <br /> From Table B............................................ Added <br /> Mfg b for",A p a subsurface water In the tank Transfer COE to Line 29b. suA M' El Y T COE to t 2�. <br /> Retr to W.F.P.A. 30, Sactlona 2-3.2.4 and 2.7.2 and the tank 25. (a� x (b) - (c <br /> s <br /> manufacturer regarding allowable system tea9 pressures. Total quantity in Caolfloient of etpaMtd fo voNme c In mfss meok ♦7 <br /> tun tante(16 or/T) ®� Imw1'�product _ °F � 4��. �p �^ <br /> 26. (a) V//® /�j C302 = . z -.a is + <br /> Vol,,rhanne per°F t25 or 24b! Digits per-F in Test Volume ttr per digit Teat <br />
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