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COMPLIANCE INFO_2002-2012
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2300 - Underground Storage Tank Program
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PR0231309
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COMPLIANCE INFO_2002-2012
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Last modified
8/12/2022 3:24:31 PM
Creation date
6/23/2020 6:45:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2002-2012
RECORD_ID
PR0231309
PE
2361
FACILITY_ID
FA0003756
FACILITY_NAME
KISHIDA, GEORGE INC
STREET_NUMBER
1725
STREET_NAME
ACKERMAN
STREET_TYPE
DR
City
LODI
Zip
95240
APN
06219001
CURRENT_STATUS
01
SITE_LOCATION
1725 ACKERMAN DR
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231309_1725 ACKERMAN_2002-2012.tif
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EHD - Public
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r <br />jOAM <br />Avf —f® ite <br />416 2nd Street Phone: <br />Gait, Ca 95632 Fal: <br />afforda@softcom.net <br />(209) 744-0112 <br />(209) 744-0116 <br />I <br />LINE & LEAK DETECTOR <br />TEST REPORT <br />CONTRACTOR/ENGINEER TEST DATE 11 / 10 / 10 <br />SITE NAME KISHIDA TRUCKING PHONE <br />SITE ADDRESS 1725 ACKERMAN DR. CITY LODI CA 95240 <br />Repair/Construction LOCATION SKETCH show North <br />® Compliance <br />SHOW STREETS, BLDGS, TANKS, ISLANDS, PIPING (IF KNOWN), PUMPS OR DISPENSERS <br />FTA LEAK DETE6TOR TEST INFORMATION <br />I <br />Calibrate <br />10 PSI <br />Insurance <br />Escrow <br />Make & Type of Pump or Dispenser <br />RED JACKET & TOHKEIM <br />Cover Over Lines <br />CONCRETE <br />Approx Burial Depth <br />3-4 FT <br />Weather <br />CLEAR, COOL <br />® Pressure Suction <br />LEAK DETECTOR <br />KEY TYPES <br />No/ <br />Product <br />LD <br />Key <br />Serial <br />Number <br />Resiliency <br />Opening <br />Time In <br />Seconds <br />Test Leak <br />Rate <br />ML/Min. <br />I Element <br />Holding <br />PSI <br />Metering <br />PSI <br />Pass/ <br />Fail <br />A LD 2000 <br />N DIE <br />D <br />65 <br />4 <br />189/3 <br />13 <br />11 <br />PASS <br />B LD 2000 E <br />C FXI V <br />S DIE <br />D <br />90 <br />4 <br />189/3 <br />15 <br />11 <br />PASS <br />D FXI DV <br />E STPMLD <br />F STPMLD — D <br />G STPMLD — E <br />H STPMLD—D/E <br />Notes: <br />CONTRACTOR <br />CERTIFICATION'j <br />Technician: <br />ZANE NIMMO <br />i' <br />LIME TEST RESULTS <br />Tests were made on the line, systems as noted in accordance with test procedures <br />prescribed for as detailed on thtest chart on Side 2 of this form with results as follows: <br />LINE IDENTIFICATION NET VOLUME CHANGE PER HOUR <br />PETROTITE CERT. #: CCA: 0202112304R <br />OTTL License #: 04-1676 <br />N. DIESEL <br />PASS FAIL❑ INCONCLUSIVE❑ <br />.0000 <br />PASS FAILU INCONCLUSIVE <br />Trainee: <br />S. DIESEL <br />PASS FAIL❑ INCONCLUSIVE <br />.0000 <br />PASS FAIL[]INCONCLUSIVE❑ <br />EQUIPMENT: PETRO TITE LINE TESTER <br />
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