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COMPLIANCE INFO_2010-2015
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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MOSSDALE
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2300 - Underground Storage Tank Program
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PR0231692
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COMPLIANCE INFO_2010-2015
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Last modified
12/28/2023 11:35:02 AM
Creation date
6/3/2020 9:51:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2010-2015
RECORD_ID
PR0231692
PE
2361
FACILITY_ID
FA0000212
FACILITY_NAME
Mossdale Chevron
STREET_NUMBER
444
Direction
W
STREET_NAME
MOSSDALE
STREET_TYPE
RD
City
LATHROP
Zip
95330
CURRENT_STATUS
01
SITE_LOCATION
444 W MOSSDALE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231692_444 W MOSSDALE_2010-2015.tif
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EHD - Public
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Maii. -inancelRepair Log and <br />ISD Alarm Log <br />Site Name: —� <br />Address: <br />City: -- -- <br />Date/Time <br />Date/Time <br />Component <br />Date/Time <br />Date of <br />Technician Information Type of <br />Name, Affiliation, Phone Service <br />Type of Service Performed and the <br />Problem <br />Removed <br />Service Call. <br />Made3 <br />a <br />Service <br />Number and Ce1SD <br />rtification (Repair orISD <br />Outcome <br />Detected' <br />from <br />Number Alarm)- <br />i2 <br />Service <br />_- — <br />-- _-- <br />--- <br />0 wt <br />6 r— <br />g6 <br />m <br />e �} <br />a <br />------ --- <br />z <br />—----.__..------------------------.._._- . -- -------- <br />---------------- <br />--------- <br />M <br />00 <br />M <br />Z <br />-n <br />t:Lm <br />Z <br />-i <br />T <br />M <br />r® <br />'Record date and time the problem was detected. Include equipment defects or ISD alarms. <br />2Record date and time component was taken out of service, if applicable. <br />3Record date and time the service call was made. <br />4Record date and time service was performed. <br />5Record certified repair technician's name, company affiliation, phone number and certification number from applicable manufacturer. <br />6Record the nature of the service call (repair or replace a component or respond to ISD alarm). Include ISD alarm type, if applicable. <br />7Record brief explanation of service performed, including outcome of service (repaired, tested and returned to service, waiting for parts, etc). Any and all actions <br />taken to identfy the cause of an ISD alarm, including the actual results of tests performed in accordance with the IOM requirements for that alarm (results <br />may be attached), must also be noted here or in supporting documents. <br />I <br />
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