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COMPLIANCE INFO_2015-2019
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231497
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COMPLIANCE INFO_2015-2019
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Entry Properties
Last modified
10/11/2023 2:05:16 PM
Creation date
6/3/2020 9:50:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2015-2019
RECORD_ID
PR0231497
PE
2361
FACILITY_ID
FA0000279
FACILITY_NAME
ESCALON MINI MART
STREET_NUMBER
1097
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
ESCALON
Zip
95320
APN
22510001
CURRENT_STATUS
01
SITE_LOCATION
1097 YOSEMITE AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231497_1097 YOSEMITE_2015-2019.tif
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EHD - Public
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01/12/2015 13:47 5596881467 <br />FRANZEN HILL <br />11 <br />PAGE 07 <br />Spill cket Testing Report Form SWRCB, Jwnwy 2006 <br />Bu <br />7710 form is intended for use by contractor- per, v#dng annual testing of &IST spill containment 8&uCturev. The colnpjer_d�f <br />Pri"t"I*firOm tests Af applicable), should be provided to rhe jacility ownerlop t b he a orin and <br />era orfor su MOW 10 1 100 1 regulatoryagency, <br />3. SPILL BUCKET TESTING DWORMAUON <br />Test MedRA u5i;;L& VM H lic --- <br />Test Equ4ment used: <br />U VBMM 0 Otber <br />Equoment <br />Tdwtifp Spill, l3iv—ket Tank -Fd ML Rut- <br />MUMb" ,q.1e1PP,4 A—A-0 -t- 1 2 9i—F <br />Bucket <br />Bucket 1n.4Al1aficm'J-ype- <br />I OAUg' <br />D <br />XG Dired Divy <br />X "Mwn, <br />xnT)h-ect Bury 0 d Direct <br />Tn�ict �Dkmtgr- <br />r "0 n tWncd <br />0 COnt2incd !21� <br />12" <br />12 " <br />n Contained in sump 0 Contakied in SMV Li Cmitaincd j -n Stu <br />12" <br />B B 'gt 1) <br />kat Depth- <br />15" <br />15" <br />15*' <br />- <br />Wag tme baview zppb=X <br />VM9 <br />tStwwt <br />waterer start of lest.. <br />of J� <br />W <br />;Test Time <br />Time (TI). <br />� <br />9. <br />9--08AM <br />"AM <br />9.V8AM <br />b JR <br />wal Reedirkg (R.T), <br />- -- <br />11519" <br />1 <br />---- - —i <br />13 W <br />Test End Tim (r;,): <br />10:08AM <br />10 -0 -9 -AM <br />MW Reaft (F,). <br />11 5/r13%- <br />Tc.st Duration (Tv - Tj): <br />I HOUR <br />I I <br />CbW9e in ROKbg (Rr - Rq), <br />0 <br />0 <br />Pass/Fadl 7shold of <br />Cvitedw <br />Twt kestft XJ Na U Fag Xi Pao u FSU U Pan U Fag <br />— U Paft U Fail <br />Comments - (include information <br />on repairs made prior <br />to twlin _&. and remmmoftAo.4 <br />CERTMCATION OF TEC CLAN RMpONSIBLE FOR CONDUCTIWC TIUS TESTING: <br />,r "reby efAPWY that all Me information eoafaine4 in this PqRW is tn� acegrate, and in fkfl comp&nce with legal requhwnenft <br />— <br />is -11") <br />Technician's <br />Date: <br />State laws and regulations do not <br />7GI mWitc testing to be performed by a qualified contactor. Tlov,-cvcr, local mqWrements <br />
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