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COMPLIANCE INFO_2020
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2300 - Underground Storage Tank Program
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PR0231476
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COMPLIANCE INFO_2020
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Last modified
1/25/2021 4:13:52 PM
Creation date
6/11/2020 10:35:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0231476
PE
2361
FACILITY_ID
FA0000684
FACILITY_NAME
QUIK STOP MARKET #125
STREET_NUMBER
1580
Direction
W
STREET_NAME
MAIN
STREET_TYPE
ST
City
RIPON
Zip
95366
APN
259-090-21
CURRENT_STATUS
01
SITE_LOCATION
1580 W MAIN ST
P_LOCATION
05
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\kblackwell
Tags
EHD - Public
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UNDERGROUND STORAGE TANK <br />SECONDARY CONTAINMENT TESTING REPORT FORM (Page 6 of 6) <br />XXI. UNDER -DISPENSER CONTAINMENT TESTING INFORMATION <br />Manufacturers <br />IdentifyUDC ID from Section III for each Manufacturer <br />Bravo <br />1 z 2 0 3 0 4 <br />❑ 5 <br />❑ 6 ❑ <br />7 ❑ 8 ❑ 9 ❑ 10 ❑ 11 <br />Ell 12 ❑ <br />1 ❑ 2 ❑ 3 ❑ 1 4 <br />❑ 5 <br />❑ 1 6 ❑ <br />7 ❑ 8 ❑ 9 ❑ 1 10 ❑ 11 <br />❑ 1 12 ❑ <br />Test Method Used: <br />❑ Manufacturer Guidelines (Specify): <br />0 Industry Code or Engineering Standard (Specify): <br />❑ Engineered Method (Specify): <br />Attach the testing procedures and all documentation required to determine the results. <br /># of Attached Pages <br />UDC Testing Training and Certifications (List applicable certifications) <br />Expiration Date <br />Bravo - SWAT <br />12/11/2021 <br />INCON - Containement Testing <br />6/6/2020 <br />INCON - Level 4 Sump Test System Operations <br />6/4/2020 <br />XXII. COMMENTS <br />Provide any additional comments here. <br />If the facility has more components than this form accommodates, additional copies of these pages may be attached. <br />UDC = Under -Dispenser Containment; ID = Identification <br />
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