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COMPLIANCE INFO_2021
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231906
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COMPLIANCE INFO_2021
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Last modified
1/12/2022 4:38:57 PM
Creation date
1/11/2021 9:57:54 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231906
PE
2361
FACILITY_ID
FA0003776
FACILITY_NAME
KWIK SERV LODI BW 113*
STREET_NUMBER
420
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06202042
CURRENT_STATUS
01
SITE_LOCATION
420 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
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 <br /> 8. SUMP/UDC TEST <br /> Test Method Developed by ❑ Manufacturer ❑ Industry Standard ® Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum ® Hydrostatic <br /> Test Equipment Used: INCON TS1000- 15 MIN. <br /> Sump/UDC ID E-85 7/8 9/10 5/6 <br /> Sump Manufacturer Unknown Unknown Unknown Unknown <br /> Sump depth (inches) N/A N/A N/A N/A <br /> Sump Bottom to Top of <br /> Highest Pipe Penetration N/A N/A N/A N/A <br /> (inches) <br /> Test Start Time 12:48 10:08 11:25 11:00 <br /> Initial Reading 2.2041 2.1878 4.0783 2.2930 <br /> Test End Time 1:03 10:24 11:41 11:15 <br /> Final Reading 2.2041 2.1875 4.0781 2.2929 <br /> Change in Reading 0 .0003 .0002 .0001 <br /> Pass/Fail Criteria 0.002 0.002 0.002 0.002 <br /> Tightness Test Results ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail <br /> Sump/UDC ID <br /> Sump Manufacturer <br /> Sump depth (inches) <br /> Sump Bottom to Top of <br /> Highest Pipe Penetration <br /> (inches) <br /> Test Start Time <br /> Initial Reading <br /> Test End Time <br /> Final Reading <br /> Change in Reading <br /> Pass/Fail Criteria 1 0.002 0.002 0.002 0.002 <br /> Tightness Test Results ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> Additional copies of this page may be attached. <br /> Page 4 of 6 <br />
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