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COMPLIANCE INFO_2019
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2300 - Underground Storage Tank Program
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PR0521866
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COMPLIANCE INFO_2019
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Last modified
9/21/2020 12:41:21 PM
Creation date
9/21/2020 9:32:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2019
RECORD_ID
PR0521866
PE
2371
FACILITY_ID
FA0014852
FACILITY_NAME
RANCHO SAN MIGUEL MARKET*
STREET_NUMBER
610
Direction
S
STREET_NAME
CHEROKEE
STREET_TYPE
Ln
City
Lodi
Zip
95240
APN
04745039
CURRENT_STATUS
01
SITE_LOCATION
610 S Cherokee Ln
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\gmartinez
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EHD - Public
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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page 4 of 6) <br /> XIII . VAPOR RECOVERY PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Smith AZ BW1 I C ❑ I D ❑ <br /> A ❑ B ❑ I C ❑ I D ❑ <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify) : <br /> ® Industry Code or Engineering Standard (Specify): Pressure <br /> ❑ Engineered Method (Specify): <br /> Attach the testing procedures and all documentation required to determine the results. # of Attached Pages <br /> Vapor Recovery Piping Containment Testing Training and Certifications (List applicable certifications) Expiration Date <br /> ICC UST Certification # 8819839 10/25/2019 <br /> Interstitial Communication Verification Method Used : <br /> XIV. COMMENTS <br /> Provide any additional comments here. <br /> Vapor return line tested at 10: 30 am at 2 psi ended at 11 : 30 am at 0 psi failed unable to reach 5 psi . Due to torn test boot. <br /> XV. TURBINE / PRODUCT PIPING SUMP TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Fiberglass A Z I B © C ❑ D ❑ <br /> A ❑ I B ❑ I C ❑ I D ❑ <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify) : <br /> ® Industry Code or Engineering Standard (Specify): Hydrostatic <br /> ❑ Engineered Method (Specify): <br /> Attach the testing procedures and all documentation required to determine the results. # of Attached Pages <br /> Turbine / Product Piping Sump Testing Training and Certifications (List applicable certifications) Expiration Date <br /> ICC UST Certification # 8819839 10/25/2019 <br /> INCON TS-STS L4 - Certification # 1019623710 9/24/2020 <br /> XVI , COMMENTS <br /> Provide any additional comments here. <br /> ID = Identification <br />
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