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COMPLIANCE INFO_2020
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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EL DORADO
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1605
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2300 - Underground Storage Tank Program
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PR0504388
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COMPLIANCE INFO_2020
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Last modified
3/8/2021 10:00:08 AM
Creation date
7/7/2020 3:29:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0504388
PE
2361
FACILITY_ID
FA0006185
FACILITY_NAME
El Dorado Gas & Mart
STREET_NUMBER
1605
Direction
S
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
16703101
CURRENT_STATUS
01
SITE_LOCATION
1605 S EL DORADO ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\kblackwell
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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 IdentifyUDC ID from Section III for each Manufacturer <br /> Bravo Systems - Coated Steel 7 8 El 9 D 0 ❑ 1 ❑ 2 ❑ <br /> 1 ❑ 1 2 ❑ 3 ❑ 4 ❑ 1 5 ❑ 1 6 ❑ <br /> 7 ❑ 1 8 ❑ 9 ❑ 10 ❑ 11 ❑ 1 12 ❑ <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify): <br /> ❑ Industry Code or Engineering Standard (Specify) : <br /> p Engineered Method (Specify): Caldwell Systems/Hydrostatic 30 Minutes <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. 2 <br /> UDC Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> Caldwell Level Change Indicator 7/5/2020 <br /> ICC Service Technician #5246802 - UT 3/21 /2021 <br /> Underground Storage Tank Tester License #90- 1120 12/31 /2022 <br /> XXIL COMMENTS <br /> Provide any additional comments here. <br /> 3 <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 /> I <br />
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