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COMPLIANCE INFO_2003-2011
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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88 (STATE ROUTE 88)
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14971
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2300 - Underground Storage Tank Program
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PR0231911
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COMPLIANCE INFO_2003-2011
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Last modified
11/20/2024 9:21:33 AM
Creation date
6/23/2020 6:53:37 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2003-2011
RECORD_ID
PR0231911
PE
2361
FACILITY_ID
FA0000540
FACILITY_NAME
COUNTRYSIDE LIQUORS & GAS
STREET_NUMBER
14971
Direction
N
STREET_NAME
STATE ROUTE 88
City
LODI
Zip
95240
APN
06316025
CURRENT_STATUS
01
SITE_LOCATION
14971 N HWY 88
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231911_14971 N HWY 88_2003-2011.tif
Tags
EHD - Public
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CONTRACTOR/ENGINEER <br />SITE NAME <br />ADDRESS <br />C6UIf-- <br />Compliance <br />Repair/Construction <br />Insurance <br />Escrow <br />e & Type of Pump or Dispenser <br />GGni' 10'� r^ 0, 0) <br />ar Over Lines <br />Approx Burial Depth <br />"7 / Y <br />416 2nd Street Gait CA 956"—" LINE & LEAK DETECTOR <br />(209) 744-0112 (209) 744-0116W TEST <br />REPORT <br />5";--// <br />LOCATION SKETCH <br />,( Pressure Suction SHov <br />'alibrated to 3 gph @ 10 psi <br />LEAK DETECTOR KEY Disp1 LD <br />Product Key <br />A LD 2000 <br />B LD 2000 E <br />C FXI V <br />D FXI DV <br />E STPMLD <br />F STPMLD - D <br />G STPMLD - E <br />H STPMLD - D/E <br />CONTRACTOR <br />CERTIFICATION <br />rechnician: Lyle D. Nim <br />3ETROTITE CERT# <br />)90993AO163 <br />)TTL Lie# ®• �h�3 <br />Frainee: <br />TEST DATE` ® 7 <br />PHONE( O/ �}l <br />snow North <br />� <br />v� V� J- <br />i <br />I STREETS, BLDGS, TANKS, ISLANDS, PIPING (IF KNOWN), PUMPS OR DISPENSERS Ic <br />41,J F7 14 (* <br />FTA LEAK DETECTOR TEST INFORMATION Calibrate <br />10 PSI <br />Opening Leak Functional <br />Time Rate Element Metering <br />Serial Number Resiliency In Seconds ML/Min Holding PSI PSI Pass / Fa <br />P / F <br />P / F <br />P / F <br />P / F <br />P / F <br />P / F <br />P / F <br />Notes: <br />LINE TEST RESULTS <br />Tests were made on the line systems as noted in accordance with test procedures <br />prescribed for as detailed on the test chart on Side 2 of this form with results as follows: <br />LINE IDENTIFICATION NET VOLUME CHANGE <br />�t t VAS _ FAIL / INCON _► SIVE p o3G <br />h P,4SS/, FAIL / INCONCLUSIVE <br />PASS,.= FAIL / INCONCLUSIVE <br />PASS / FAIL / INCONCLUSIVE <br />f7 <br />
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