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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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REYNOLDS RANCH
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2300 - Underground Storage Tank Program
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PR0535432
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COMPLIANCE INFO_2021
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Last modified
1/3/2022 4:03:29 PM
Creation date
1/20/2021 9:53:12 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0535432
PE
2351
FACILITY_ID
FA0020431
FACILITY_NAME
COSTCO WHOLESALE #1091
STREET_NUMBER
2680
STREET_NAME
REYNOLDS RANCH
STREET_TYPE
PKWY
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
2680 REYNOLDS RANCH PKWY
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
Tags
EHD - Public
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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> 6. SPILL CONTAINER DETAILS <br /> Test Method Developed by N Manufacturer N Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum N Hydrostatic <br /> Tank ID T1 87A Fill T2 87B Fill T3 91 Fill T4 Addv Fill <br /> Spill Container Manufacturer: OPW OPW OPW OPW <br /> Method of Cathodic Protection N Nonmetallic N Nonmetallic N Nonmetallic N Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum N Yes N Yes N Yes N Yes <br /> capacity five gallons excluding El No* El No* ❑ No* El No* <br /> riser volume? <br /> N Drain N Drain N Drain N Drain <br /> Method to keep spill container ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> empty ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results N Pass N Pass N Pass N Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> Tank ID <br /> Spill Container Manufacturer: <br /> Method of Cathodic Protection ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ❑ No* El No* El No* El No* <br /> riser volume? <br /> ❑ Drain ❑ Drain ❑ Drain ❑ Drain <br /> Method to keep spill container ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> empty ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 8. COMMENTS <br /> Describe all answers marked "Other," "No,"or "Fail"and each proposed remedy. <br /> * Mark here if: <br /> ❑ Spill containers do not have a minimum capacity of five gallons and require replacement. <br /> Additional copies of this page may be attached. <br /> Page 2 of 2 <br />
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