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COMPLIANCE INFO_2020
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231554
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COMPLIANCE INFO_2020
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Last modified
4/28/2021 3:42:08 PM
Creation date
6/11/2020 2:09:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0231554
PE
2361
FACILITY_ID
FA0005678
FACILITY_NAME
LATHROP SHELL
STREET_NUMBER
16500
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
LATHROP
Zip
95330
CURRENT_STATUS
01
SITE_LOCATION
16500 S HARLAN RD
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
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SJGOV\gmartinez
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EHD - Public
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IN <br /> UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM ( Page 6 of 6) <br /> XXI . UNDER-DISPENSER CONTAINMENT TESTING INFORMATION <br /> Manufacturer(s) : Identify UDC ID from section III for each Manufacturer <br /> S Bravo 10 20 3 ® 4 M 5 E 6 ❑ <br /> 7 ❑ 8 E 90 101`71 11 ❑ 120 <br /> 1 ❑ 20 3 E 4 ❑ 5 ❑ 6 ❑ <br /> 7 ❑ 8 E 9 E 10 El 11 ❑ 12 El <br /> Test Method Used : <br /> ❑ Manufacturer Guidelines : (Specify) <br /> ❑ Industry Code or Engineering Standard : (Specify) <br /> ® Engineered Method : (Specify) Caldwell Systems/Hydrostatic 30 Minutes <br /> Attach the testing procedures and all documentation required to determine the results. # of Attached Pages <br /> UDC Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> Caldwell Level Change Indicator 05/31 /2022 <br /> XXII . COMMENTS <br /> Provide any additional comments here. <br /> Dispenser 7 - 8 UDC failed the hydrostatic test due to bad electrical penetration fitting . Fitting <br /> must be repaired/replaced and UDC retested with passing result . <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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